Thyroid is an organ in the body with most diverse biology among tumors. Even the best of the pathologists cannot say that it is cancer or not when thyroid tests are done.

Sometimes, in presence of a nodule and when test results are not accurate, operations are needed to confirm the diagnosis.

These operations can be of following types-

  1. Open biopsy- A small part of nodule or thyroid tumor is taken out by an operation.
  2. Nodulectomy- Some surgeons who are not expert in thyroid surgery may perform nodulectomy which is removal of nodule only. However, this type of surgery should not be performed.
  3. Thyroid Lobectomy- Thyroid has two lobes; right and left. If nodule is in one lobe, that lobe is removed and send for tests. This removal of a lobe is known as lobectomy.
  4. Hemithyroidectomy- When one lobe of thyroid is removed along with its connecting part (isthmus) with the other lobe and also the removal of pyramidal lobe, it is known as hemithyroidectomy.
Hemithyroidectomy

Hemithyroidectomy specimen

5. Lymph node biopsy- Sometimes, thyroid nodules are associated with enlarged lymph nodes on side of the neck. When diagnosis is not confirmed, then the lymph node may be removed by biopsy and send for testing.

The tumor piece of thyroid or lymph node which is removed is send for histopathology. This histopathology report confirms the diagnosis and then appropriate action can be taken. Example, if histopathology detects that there is cancer, then second surgery may be required to remove all thyroid. However, if histopathology says that it is non cancer, then no further action is required and patient can remain disease free.

In a minor proportion, a further special stain technique called as Immunohistochemistry is done over the histopathology sample. These all may be required to reach to a final and accurate diagnosis.