Differentiating Cervical Lipomas From Thyroid Nodules-Reply

In Reply.— We appreciate the remarks of Andrews and colleagues regarding the use of FNA in diagnosing thyroid masses. The major thrust of our article is that cervical lipomas can be mistaken for nonfunctioning thyroid nodules, thereby leading to unnecessary surgery or medical therapy. Our purpose is to familiarize our colleagues with this possibility. We actually conclude that "a high degree of suspicion and the use of CT can establish the correct diagnosis." We certainly do not advocate the routine initial use of CT in evaluating thyroid nodules. However, where there is a high index of suspicion for a lipomatous tumor, a CT scan can be diagnostic. In regard to the comments of Andrews and colleagues on the usefulness of FNA in the evaluation of "cold" thyroid nodules, we certainly agree. We are quite familiar with the advantages and limitations of FNA. 1,2 In fact, we are pleased to learn