Clinical indications for FNAC

  • Suspicious clinical findings: Rapidly growing, firm mass, thyroid asymmetry, cervical lymphadenopathy, recent onset hoarseness/ vocal cord paralysis
  • Palpable firm thyroid nodule: FNAC of thyroid nodule
  • Palpable firm cervical lymph node: FNAC of node +/- thyroid nodule
  • Factors that may be considered in addition to above suspicious clinical findings: Prior thyroid cancer, radiation exposure, 1st degree relative with thyroid cancer of MEN2, FDG avid on PET scan, thyroid cancer associated history e.g. familial adenomatous polyposis, Carney complex, Cowden syndrome
  • If FNAC not indicated, repeat exam after 6-12 months; if stable for 1-2yrs, then consider review at 3-5 yearly intervals

Index: Clinical Practice Guidelines for Thyroid