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Depending on the findings, further investigations may be arranged, such as: Blood tests including thyroid function tests (TSH, free T4) Ultrasound scan of the neck and thyroid Fine needle aspiration (FNA) biopsy if a suspicious nodule is identified Referral to an endocrinologist or ear, nose, and throat (ENT) specialist According to NICE guidance (NG12), an unexplained lump in the neck or persistent unexplained hoarseness may warrant referral via the suspected cancer pathway (two-week wait)

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