What is a thyroid nodule?
Thyroid tissue is generally a uniformly textured glandular tissue. If there is an abnormality in the hardness or structure of one part of the thyroid tissue, this localized abnormal area is called a nodule. A nodule is only a morphological term and can manifest a variety of thyroid disorders, including hyperplasia, inflammation, cysts, adenomas, and tumors.
The current detection rate of thyroid nodules in the population is very high, and according to statistics, the detection rate of ultrasound examination is 20% to 70%, what causes thyroid nodules? The causes can be broadly summarized as follows.
1, genetic factors or autoimmune factors: If there are patients with thyroid nodules in the family, the incidence of thyroid nodules is higher than in the general population; abnormal autoimmune mechanisms may be roughly the formation of thyroid nodules.
2, iodine excess: the body was not iodine deficient, but long-term consumption of a large amount of iodine-containing food, coupled with the usual diet is added to the iodized salt, may cause iodine excess, stimulating the formation of nodules in the thyroid gland.
3. Progress in examination technology: In the past, thyroid examinations were done by palpation, and most of the thyroid nodules were small and limited to the physician’s technique, so the detection rate of nodules was very low. However, with the development and popularity of high-frequency ultrasound technology, color ultrasound can detect nodules as small as 2 to 3 mm, and with the increase in the number of health checkups, the incidence of thyroid nodules detected by medical screening has also increased.
4, history of radiation exposure to the neck: after long-term or cumulative exposure to radiation exposure to the neck, abnormal hyperplasia of thyroid tissue occurs, especially the chance of cancerous nodules also increases.
5.Environment or stress: With the change of people’s living environment and the increasing pressure of work and life, it may lead to an increase in the incidence of thyroid nodules.
The incidence of thyroid nodules in women is significantly higher than in men, about 4:1, because the thyroid gland is an endocrine organ of the human body, especially in women where endocrine changes in estrogen levels occur, resulting in a higher incidence of thyroid nodules in women as well.
Do I need surgery if I find a thyroid nodule?
Generally speaking, most thyroid nodules are asymptomatic and are found during physical examinations. The need for surgery for thyroid nodules can be evaluated from three aspects: nature, size and function.
1, from the nature of the assessment, if the nodules are considered or tend to be malignant then surgical treatment is required, there are the following cases.
1. The sensitivity of ultrasonography of thyroid nodules is high, and the detection rate of malignancy is around 80%. Ultrasonography with suspicion of malignancy is characterized by 1. hypoechoic nodules; 2. nodules with burrs around the periphery, poorly defined borders, and no envelope; 3. standing long (often described by ultrasound as an aspect ratio >1); 4. with microcalcifications; 5. particularly rich blood flow; 6. thyroid nodules found with abnormal enlargement of the cervical lymph nodes, excluding Other causes of lymph node enlargement.
②Nodules were diagnosed as malignant or predisposed to malignancy by fine needle aspiration pathology.
③The characteristics of rapid growth, hardness and poor mobility do not exclude the nodes as malignant.
④If the nodule size exceeds 50% within six months, such nodules have a tendency of malignant transformation.
2.If the nodule is not considered malignant after nature assessment, benign nodules may have the following conditions.
①Benign nodules are too large and compress the surrounding trachea or esophagus, causing difficulty in breathing or swallowing and requiring surgery.
②Thyroid nodules that grow behind the sternum are ectopic thyroid nodules and require surgery.
③Thyroid nodules that are relatively large and affect the aesthetics can be considered for surgical treatment.
3. Assessment in terms of function.
Those who are found to have thyroid nodules and have combined hyperthyroidism need surgical treatment.
After the above three comprehensive assessments, we basically understand whether to operate on thyroid nodules or not.
Can thyroid nodules be treated with medication after they are found?
Medications (mainly eugenol) have some effect on thyroid nodules, such as inhibiting the growth rate of the nodule, but the effect is limited because the nodule has already formed and there is little chance of making it shrink. However, suppressive therapy with medications after thyroid surgery is an important adjunctive treatment.
Do thyroid nodules affect the function of the thyroid gland?
Thyroid nodules that are tiny and solitary generally do not have a significant endocrine impact. In Hashimoto’s thyroiditis, the presence of diffuse, multiple nodules may affect the synthesis and release of thyroid hormones, leading to abnormal thyroid function. Or a high-secreting, high-functioning adenoma may form in the thyroid gland leading to hyperthyroidism.
Regular review of thyroid nodules
Except for thyroid nodules that require surgery, all thyroid nodules need to be reviewed periodically. The purpose of periodic review is to observe the growth rate and morphological changes of thyroid nodules, especially those with partial malignant features but atypical nodules, in order to determine the options for further diagnosis and treatment. The frequency of regular review of thyroid nodules is usually every three months or six months, up to one year. The main method of periodic review is to choose ultrasound review and, if necessary, puncture cytology.