Thyroid: follicular neoplasm: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Thyroid: follicular neoplasm

Sample item

Fine-needle aspiration of a solitary thyroid nodule in a 40-year-old woman reports a 'follicular neoplasm'. What is the most appropriate next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Diagnostic hemithyroidectomy with histology

Cytology cannot distinguish follicular adenoma from follicular carcinoma, because the diagnosis of carcinoma depends on capsular or vascular invasion, which needs histological examination of the whole nodule. A lobectomy gives the diagnosis, and completion thyroidectomy follows if invasive carcinoma is found.

Option by option

  • A. Repeat FNAC every 6 months only

    Repeating cytology will not resolve the uncertainty.

  • B. Radioiodine ablation

    Radioiodine is used after surgery in selected cancers.

  • C. Total thyroidectomy with neck dissection

    Radical surgery is not justified before a diagnosis, and neck dissection is for nodal disease.

  • D. Diagnostic hemithyroidectomy with histology (correct)

    Correct. Only histology of the whole lesion can show capsular or vascular invasion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Diagnostic hemithyroidectomy with histology. Cytology cannot distinguish follicular adenoma from follicular carcinoma, because the diagnosis of carcinoma depends on capsular or vascular invasion, which needs histological examination of the whole nodule.

Why is "Repeat FNAC every 6 months only" not the answer?

Repeating cytology will not resolve the uncertainty.

Why is "Radioiodine ablation" not the answer?

Radioiodine is used after surgery in selected cancers.

Why is "Total thyroidectomy with neck dissection" not the answer?

Radical surgery is not justified before a diagnosis, and neck dissection is for nodal disease.

What concept does this question test?

It tests Thyroid: follicular neoplasm in General Surgery. A lobectomy gives the diagnosis, and completion thyroidectomy follows if invasive carcinoma is found.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thyroid: follicular neoplasm?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.