Diagnosis begins with a history and physical examination; however, not all cancerous nodes are palpable, as noted on the previous page (see Symptoms), and a medical history is only a probabilistic guide. One or both of the following tests may be performed depending on your particular case:


Ultrasound examination uses harmless sound waves to obtain a picture of the tissues of the neck. This technique is much better at detecting abnormal lymph nodes than a physical exam alone.

You may have already had an ultrasound of your thyroid, but this initial ultrasound does not usually include an examination of the lymph nodes. Thus, another full neck ultrasound may need to be performed. This ultrasound will evaluate for abnormal lymph nodes right around your thyroid as well as along the jugular veins which run along the sides of your neck.

Thyroid Ultrasound
Doctor Looking Through Microscope


Not all abnormal lymph nodes detected through an ultrasound actually contain cancer. The best way to determine if an abnormal lymph node contains cancer is to do a fine-needle aspiration (FNA) biopsy. (You may have already had an FNA of your thyroid.) The skin is prepared and a needle is inserted into the abnormal lymph node by ultrasound guidance. Cells from the lymph node are removed and examined by a pathologist.

This information is provided by the Department of Surgery at the University of Colorado School of Medicine. It is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.