London Calling! What is US protocol for follical lessions?

[4helen]

Have THY4 (ie suspicious cells) pathology report on 2nd biopsy (1st was inconclusive)  of 4cm rt lobe - suspected follicular lession which may or may not be malignant.  Only had biopsy done + full bloods that say thyroid function normal.  ENT wants to head straight to the OR!!

I had the nodule scanned four years ago and it grew only 1 cm in that time. It was not biopsied then (had no idea it should have!) and there was another 1.2cm one that has since disappeared.

What is US practice ----ie are there any other tests performed to assist diagnosis? It is a suspected follicular lession and I have been told that only surgery can diagnose properly. Is this so?

Can people wait and watch?

I will seek other ENT opinions - possibly even coming back home (am American) as I worry about not getting best practice here.

In the panic which is taking over my life managing 4 kids etc - I realized that I had the Mirena coil fitted 3 yrs ago; I have since had it whipped out lickety quick but -------can't believe there may not be a connection!!!  
Anybody else think so? It was fitted for heavy bleeding - a thryoid related matter, no?

Does size of lession matter??

Thank you all in advance for any help, advice, assistance, and or kindly word!

[4helen]

Thank you so much for the info.  ENT never mentioned a core biopsy.  Worth doing indeed.

[898]

If the case is doubtful, core biopsy is recommended [for nodule can be palpated or visble --means it is not deep inside it can be performed fairly easy]. Unlike FNA,  this procedure will provide tissue sample, not the loose cells. the cells are the same for follicular adenoma amd follicular variant of paillary carcinoma; the pattern how are they arranged in the tissue can tell the difference between cancer and non cancer.
the size does not really matter; if nodule has well defined borders the cancer is usually fully contained inside the nodule.