As with all medical issues the first step is a clinical assessment, including a detailed history and an examination of the neck.
All newly diagnosed neck lumps are best assessed with an ultrasound scan. Thyroid nodules can be graded on appearance by ultrasound. The grade of a nodule indicates if it has a reassuring benign (non-cancerous) appearance or might be suspicious for cancer. Benign nodules assessed in this way may not require any further evaluation provided there are no additional concerns such as rapid growth, recent voice changes or other findings such as enlarged neck lymph nodes. Nodules that require further investigation are sampled by fine needle aspiration where cells are taken from the nodule using a needle under ultrasound guidance. Other tests include blood tests (including thyroid function tests and anti-body testing if required), thyroid uptake scans (to detect hot nodules) and CT and MRI scans (normally reserved for much larger glands if the ultrasound indicates the nodule extends in to the chest).
