Cold thyroid nodule reduction with L-thyroxine can be predicted by initial nodule volume and cytological characteristics

• Published in: The journal of clinical endocrinology and metabolism 1996-12, Vol.81 (12), p.4385-4387
• Main Authors: LA ROSA, G. L, IPPOLITO, A. M, LUPO, L, CERCABENE, G, SANTONOCITO, M. G, VIGNERI, R, BELFIORE, A
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Endocrinopathies; Humans; Medical sciences; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Prospective Studies; Thyroid Nodule - drug therapy; Thyroid Nodule - pathology; Thyroid. Thyroid axis (diseases); Thyroxine - therapeutic use
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.81.12.4385

In a previous study we demonstrated that a 1-yr treatment with L-T4 induces substantial nodule volume reduction (> or = 50%) in approximately 40% of patients with a benign solitary cold thyroid nodule. The present prospective study investigated whether it is possible to identify, before starting L-T4 treatment, nodules with a high probability to shrink in response to L-T4. We recorded several clinical and cytological features in a continuous series of 42 patients with a cold nodule and related them to the nodule volume response to 1-yr treatment with L-T4. Fisher discriminant analysis showed that a combination of some cytological features (colloid, degenerative changes, cellular hyperplasia, and fibrosis) and initial nodule volume can be used for predicting nodule volume reduction. In fact, although only 33% of all nodules shrank, 62% of colloid nodules and 57% of small degenerative nodules shrank. None of the hyperplastic or fibrotic nodules shrank. These results were validated in a different retrospective series of 46 patients and allowed us to predict nodule reduction in over 80% of the cases.