Every time I see a clinic, there are always many patients who walk in with a medical report and say anxiously, “I had this checkup and the doctor said I have a thyroid!” In fact, everyone has a thyroid gland. The thyroid gland is an essential endocrine organ in our body, presiding over the growth and development, metabolism of life’s important tasks. To put it simply, the thyroid gland is closely related to how tall and smart children are, and how well adults feel and work. Zhou Guangwen, Department of General Surgery, Shanghai Sixth People’s Hospital
So what exactly does the physical examination reveal? Generally speaking, it means that thyroid nodules are found. Objectively speaking, it would be unfair to classify all thyroid nodules as diseases without discrimination. As we age, like any organ in the body, the thyroid gland undergoes degenerative changes. Just as there are a few gray hairs on the head and a few wrinkles on the face, the thyroid gland will develop more or less nodules at a certain age, and most of these nodules are benign. Of course, like other organs in the body, the thyroid gland can be malignant, so it is important to pay attention to medical checkups and seek timely medical attention as an important barrier to health.
How can we determine whether a thyroid nodule is benign or malignant? First, according to the progression of the disease. The presence of a thyroid nodule in adolescents requires vigilance, while the presence of a large, growing lump in middle-aged or older people should be taken seriously. Secondly, according to the auxiliary examination. The easiest and most effective way to diagnose thyroid nodules is high-frequency color Doppler ultrasound, often referred to as “ultrasound”, which not only measures the size of the nodule, but also observes the nodule pattern. If certain nodules are found, especially substantial nodules with irregular shape, unclear borders, gravel-like calcifications and abnormal internal blood supply, further examination and treatment are needed. An experienced diagnostic ultrasonographer can often determine the nature of a nodule based on its image. The most direct way to determine the nature of a nodule is to perform a fine-needle aspiration cytology, in which a needle as thick as the one used to draw blood is inserted into the nodule to be diagnosed, and some thyroid cells are extracted for smear, stained, and then observed under a microscope for cell morphology and structure. This is a convenient, economical and minimally invasive diagnostic method that is used in Europe and the United States as a first-line diagnostic tool for thyroid disease. In addition, blood should be drawn to test thyroid function after nodules are found. In addition to determining the presence of hyper- or hypothyroidism, it can also screen for thyroiditis and can be used to detect medullary thyroid carcinoma, a rare but possibly hereditary malignancy of the thyroid gland. Of course, the final diagnosis of the nature of the thyroid nodule depends on the gold standard of surgical pathology.
Nodules that are suspected to be malignant on all tests should be removed promptly. It should be noted that most thyroid cancers are papillary or follicular carcinomas, which are less malignant and can be cured with active and standardized treatment to achieve the same quality of life and life expectancy as normal people. Therefore, there is no need to worry too much. If the nodule is large enough to produce pressure such as breathing and swallowing discomfort, it should be treated surgically. Since some or all of the thyroid gland is removed, postoperative thyroxine supplements may be required to maintain normal thyroid function and reduce the chance of nodule recurrence. For the vast majority of benign thyroid nodules that do not produce symptoms, the option to live with them for the rest of their lives is mostly available. Regular review and follow-up is essential, and more importantly, adherence to good lifestyle habits is essential. First, maintain a cheerful mind, cultivate a tolerant personality, and regulate mental stress in a timely manner. “It’s hard to be happy” is a wonderful recipe for health care for all organs. Second, moderate intake of iodine. Iodine is an essential trace element for the body and directly maintains the balance of thyroid function. Too little or too much intake can have a negative impact on the thyroid gland. Thirdly, try to avoid violent coughing, loud shouting, and explosive exertion to reduce bleeding in the nodules, otherwise they may increase in size at once and produce compression symptoms.
After listening to the detailed explanation, the patient’s furrowed brows relaxed and he breathed a long sigh of relief, saying, “I’m relieved now.” Let’s go for a thorough set of related tests and get rid of this “patient” hat from the sky.