Diagnosis of thyroid neoplasms: state of the art on 2018

Currently around the world has significantly increased the detection of thyroid nodules. Patients are 60 years old have nodules in the thyroid gland in about 50% of cases and the growth of diagnostics nodules is mainly due to the expansion of the using of screening ultrasound of the thyroid gland. The “gold standard” of diagnosis after ultrasonography remains fine-needle aspiration biopsy, however, approximately 10–30% of cases, cytological result is indeterminate. The indeterminate diagnosis category represents a challenge to clinicians, as most nodules in cases of indeterminate thyroid FNAs are found to be benign in the surgically resected specimens. In this regard, additional methods are needed for pre-operative diagnosis, which would help to understand the nature of thyroid nodules, to reduce the number of diagnostic operations and to improve the quality of patient treatment. In recent years, significant changes have occurred in the diagnosis of thyroid tumors, which we will consider in this review: revision of the protocol TI-RADS, classification Bethesda, change in histological classification and the emergence of a new group of NIFTP. A large number of studies in the field of molecular diagnostics, we will consider the possibility of using molecular testing for diagnostic purposes and the introduction of these methods in clinical practice.