Contenido principal del artículo

Marta Rodríguez González
Doctora, Licenciada Especialista
España
https://orcid.org/0000-0001-8544-6201
Cristina González Velasco
Licenciada Especialista
España
https://orcid.org/0000-0001-7025-8259
Asunción Gómez Muñoz
Licenciada Especialista
España
https://orcid.org/0000-0003-3544-7753
José María Sayagués Manzano
Doctor
España
https://orcid.org/0000-0003-0582-3500
María Dolores Ludeña de la Cruz
Doctora, Licenciada Especialista
España
https://orcid.org/0000-0003-3991-5956
Vol. 12 Núm. 4 (2021), Artículo de revisión, Páginas 303-312
DOI: https://doi.org/10.14201/orl.25005
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Resumen

Introducción y objetivo: La punción aspiración con aguja fina es el método de elección para el diagnóstico del nódulo tiroideo, permitiendo discriminar entre lesiones malignas y benignas en un alto porcentaje de pacientes. Sin embargo, las categorías diagnósticas I (No diagnóstico o insatisfactorio) y III (Atipia o Lesión folicular de Significado Incierto) del Sistema Bethesda suponen un reto en el manejo de los nódulos tiroideos. El objetivo del presente trabajo es exponer las opciones de que se disponen en el momento actual para intentar incrementar la rentabilidad de estos diagnósticos. Síntesis: En primer lugar, el abordaje multidisciplinar de los casos, la posibilidad de seguimiento, la repetición de la punción aspiración, la complementación del diagnóstico incorporando técnicas inmunohistoquímicas o moleculares, y finalmente la posibilidad de realizar una biopsiacilindro. Conclusiones: Estas alternativas son especialmente útiles en la categoría diagnóstica III, mientras que se prefiere la opción de seguimiento o repetición de PAAF en la categoría diagnóstica I.

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