When people find nodules on their thyroid after physical examination, they are often nervous and apprehensive, fearing that they have an incurable disease. According to foreign statistics, 60%-87.6% of middle-aged and elderly women have large or small nodules on the thyroid gland. Are all thyroid nodules malignant; and do all thyroid nodules need surgery? The answer is no. The main symptoms to be alerted to pay attention to —— thyroid cancer When thyroid nodules are found, the medical report will usually recommend you to go to the thyroid surgery department for further diagnosis and treatment, and the specialist will have to make detailed Ask for your medical history and examine the patient. Thyroid cancer is highly suspected if: thyroid nodules are found in childhood (50% may be malignant); young men with a single thyroid nodule; thyroid nodules that grow rapidly in a short period of time; hard, large, fixed and inactive thyroid nodules; accompanied by hoarseness of voice, difficulty in swallowing, or enlarged lymph nodes in the neck; suspicion that the thyroid gland is cancerous. ——– preferred Neck ultrasound Based on the history and physical examination, the doctor will usually ask the patient to undergo the following examinations Ultrasound of the neck (color ultrasound) It is the preferred method of diagnosing thyroid nodules. Experienced doctors can determine the nature of thyroid nodules by color ultrasound with an accuracy of 90-98.5%. Therefore patients with thyroid nodules detected by palpation can have an ultrasound to further clarify the diagnosis. The image condition of ultrasound has the following characteristics: —– Benign nodular goiter is the most common, most of the ultrasound images show multiple uneven echoes, cysts usually show hypoechoicity, and the cysts may appear as light spots if there are hemorrhagic spots within the cyst. Those with eggshell calcifications can have significant strong echoes. —– The sonogram of nodular goiter combined with verrucous hyperplasia may show a parenchymal component. There is usually no blood flow in and around the mass. — Malignant thyroid nodules, with papillary thyroid carcinoma being the most common, have typical ultrasound features: 1. Hypoechoic nodule, which is characterized by: unclear margins and uneven echogenicity within the nodule.2. Irregular and disorganized blood flow in the center of the nodule.3. Multiple dots of strong echogenicity, or grit-like calcification.4. Vertical-to-transverse ratio greater than 2:1.5. Accompanied by cervical Lymph node enlargement. The more of the above signs, the greater the likelihood of thyroid cancer. In particular, multiple punctate echoes or sand-like calcifications are almost the signature ultrasound features of thyroid cancer. Fine needle aspiration cytology (FNC) The advantage of this test is the ability to obtain a cytologic or pathologic diagnosis with 95% accuracy in differentiating between benign and malignant nodules. The disadvantages are that it is invasive and follicular adenocarcinoma is not easily diagnosed. In chronic lymphocytic thyroiditis, serum tests for thyroglobulin antibodies (TGA) or thyroid microsomal antibodies (TPO) are significantly elevated. Serum tests for thyroglobulin antibodies (TGA) do not differentiate between benign and malignant nodules, as benign thyroid tumors and nodular goiter can be high. They can be elevated in cases of damage to the thyroid gland caused by surgery, inflammation, trauma, infection, radiation, and so on. Serum calcitonin testing is characteristic for the diagnosis of medullary thyroid carcinoma. Thyroid radionuclide scan (ECT) With the advancement and improvement of ultrasound diagnostic technology, thyroid radionuclide scan has been rarely used, and its findings usually show cold nodules, cool nodules and warm nodules, hot nodules. There are 18.4%-54.5% of single cold thyroid nodules that are thyroid cancer, but there are also 4-7% of hot nodules that are cancer. It is therefore difficult to differentiate the nature of thyroid nodules and has been gradually replaced by ultrasound. Final recommendation: Adhere to regular follow-up visits, pay attention to review, compare before and after, and if there is a change, “take it down by law”!