Thyroid Nodules

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To the Editor: Burman and Wartofsky (Dec. 10 issue)1 describe a clinical approach to thyroid nodules and indicate that a “radioisotopic (iodine-123 or technetium-99m) scan with measurement of radioisotope uptake to confirm autonomous function is indicated only if the thyrotropin level is suppressed.” We think that a thyroid radioisotope scan may be considered in patients with findings on thyroid fine-needle aspiration that are suggestive of a follicular neoplasm, particularly if the thyrotropin level is in the lower end of the normal range. Although there is a low likelihood of finding a functioning nodule when thyrotropin levels are not suppressed, this . . .

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