Thyroid nodules are currently a very common clinical problem. Due to the wide availability of non-invasive diagnostic methods, their detection in recent years has dramatically increased. The crucial part of management is a careful selection of appropriate therapy, based on the proper stratification of the risk of malignant changes. In order to exclude or confirm the nature of the nodule, a variety of tests are used, always starting from properly taken medical history and a physical examination. The imaging method of the greatest importance is ultrasonography. The classification of the cytological image according to the international Bethesda system allows for deciding regarding therapeutic management. However, this method has limitations. It is impossible to make a certain diagnosis in some cases. Particularly problematic are changes classified as category III or IV, so-called indeterminate cytology. Although the management in such cases is strictly defined, it is necessary to consider carefully the results of all additional tests. Observation is recommended in most cases of benign nodules (Bethesda II category). The surgical procedure is the basic therapeutic method in patients with malignant lesions (Bethesda V and VI categories), which are a small percentage of all thyroid lesions. Thyroid nodules in most cases should not be a cause for concern and should not be identified with a malignant neoplastic process. The current variety of diagnostic possibilities significantly increases the chance to correctly determine the risk of malignancy and avoid unnecessary surgical interventions in cases of benign lesions.

Key words: thyroid nodules, management, fine needle aspiration, indeterminate cytology.