Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other sites. SlideServe reserves the right to change this policy at anytime.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
Fast Track Referrals
Consultant ENT Surgeon
Palpable lymphadenopathy is common – 55% of children aged 6-12/12 and 41% of children aged 2-5 years.
Palpable liver or spleen
Larger size and progressive (>3cm)
However - Majority of nodes will be benign
Consider USS - most useful non-invasive?
Viral titres – may help in 10% of cases
If investigations unhelpful and nodes persistent or enlarging - consider need for excision biopsy.
Common – Palpable nodules in 5% of women and 1% of men worldwide.
Ultrasound can detect nodules in 19-67% of randomly selected individuals – more common in women and the elderly.
How do we select for further investigation / treatment?
Differentiated Thyroid cancer – 90%.
Incidence of papillary thyroid cancer increasing – 49% of increase <1cm and 87% <2cm.
Due to increased detection and early diagnosis with USS?
Thy1 – Repeat – USS guidance.
Thy2 – Consider interval USS and repeat.
Thy3a – MDT - Repeat biopsy / surgery
Thy3f – MDT - Surgery
Thy4 – MDT - Surgery
Thy5 – MDT - Surgery