Routine medical checkups always include a preliminary neck examination, but it is this seemingly simple “touch” that has caused some people to be “touched” – the physical examination report has more The five big words “thyroid nodules” on the medical report. If you upgrade your medical checkup and do one more thyroid ultrasound, I believe more people will become “nodule family”. Some people are very nervous when they hear the word “nodules”, fearing that they have an incurable disease; others think that nodules are no big deal, neither painful nor itchy, so let it go. In fact, these two extreme views are not scientific. Nodules are a sign of many thyroid diseases, from the most common nodular goiter, thyroid cyst, thyroid adenoma, to the dangerous thyroid cancer. Thus, it is not advisable to be nervous or leave it alone. Once a thyroid nodule is detected, it is only scientific to do further examination and evaluation to determine its nature at the first opportunity. The doctor should take a complete medical history of the patient and do a detailed examination of the thyroid gland and nearby cervical lymph nodes. Once the presence of locally enlarged lymph nodes is detected, the nature of the nodule should be highly suspected. In addition, if there are thyroid cancer patients in close relatives or if the lump is growing rapidly causing compression of adjacent organs such as trachea, with history of dyspnea, dysphagia, hoarseness, etc., all suggest that the nodule is more likely to be malignant. Ultrasound – non-invasive, quick and inexpensive first look at the nature of the nodule When it comes to determining the nature of the lump, many people first think of doing CT or MRI. In fact, for a more superficial organ like the thyroid, ultrasound can be used to get a clear view of the whole picture. Ultrasound is now so advanced that it can detect microscopic nodules as small as 2 mm in diameter, and can faithfully show not only the size, shape, border and location of the nodule, but also whether it is calcified and what the blood flow is like. If tiny calcifications are found in the nodules, with local hypoechogenicity and a rich blood supply between the nodules, it suggests the possibility of malignancy and further examination should be done. The non-invasive, fast and inexpensive nature of ultrasound is the first choice for determining the nature of thyroid nodules, but this does not mean that CT and MRI are meaningless. the higher spatial resolution of CT and MRI has a greater advantage in pinpointing nodules and their relationship to adjacent tissues (e.g., important blood vessels, nerves, etc.) and is necessary for patients who need surgery. ”Temperature” reveals the nature of the nodule The thyroid gland has a special “taste” for iodine, and all the iodine consumed by the body is concentrated in the thyroid gland. This feature facilitates the examination of the thyroid gland by nuclear medicine. A small amount of radioactive iodine isotope is introduced into the body and enriched in the thyroid gland through blood circulation. By means of a special gamma-ray camera, the thyroid gland can then be visualized. Depending on the concentration of iodine in the thyroid tissue, it is marked with a different color. Nodules with less iodine uptake are darker and are called “cold nodules”; nodules with the same level of iodine uptake as the surrounding tissue are called “warm nodules”; nodules with more iodine uptake than the surrounding tissue are more brightly colored and are called “hot nodules”. If the amount of iodine absorbed is more than the surrounding tissue, the color is brighter and the nodule is called a “hot nodule. The “temperature” reveals exactly the nature of the nodule. In general, malignant nodules are less likely to absorb iodine, so if a nuclear medicine examination reveals “cold nodules”, it is important to be highly alert. If the nature of the nodule cannot be determined by conventional imaging and laboratory tests, a puncture may be performed to extract some of the nodule cells for pathological examination. However, one negative test result is not indicative of the problem, and it is possible that cancerous cells may not be extracted exactly. Therefore, patients with thyroid nodules should be followed up regularly according to medical advice and closely monitor the movement of the lesion. Once all evidence suggests that the nodule has a tendency to become malignant, it should be surgically removed without hesitation.