What diseases cause thyroid nodules?
Thyroid nodules can have a variety of causes.
1. Hyperplastic nodular goiter
High or low iodine intake, consumption of goiter-causing substances, consumption of goiter-causing drugs, or defects in thyroid hormone synthetase, etc.
2.Neoplastic nodules
Benign thyroid tumors, papillary thyroid tumors, follicular cell carcinoma, medullary thyroid carcinoma, undifferentiated carcinoma, lymphoma and other malignant tumors of follicular and non-follicular cells of the thyroid gland, and metastatic carcinoma.
3.Cysts
Nodular goiter, degenerative adenoma and old hemorrhagic spot cyst, cystic thyroid cancer, congenital thyroglossal cyst and cyst caused by the remnants of the fourth gill slit.
4.Inflammatory nodules
Acute septic thyroiditis, subacute septic thyroiditis, and chronic lymphocytic thyroiditis can all appear in the form of nodules. In rare cases, thyroid nodules are due to tuberculosis or syphilis.
What tests should be performed in patients with thyroid nodules?
Depending on the nature of the thyroid nodule, the following tests may be required.
1.Serology tests
2.Nuclear scan
3.Ultrasound diagnosis
4.Other nuclear tests
5.Fine needle aspiration cytology
6.Thyroid fine needle aspiration cytology (FNAC)
7.X-ray of the neck
8.Thyroid function measurement
How are thyroid nodules treated?
1. Substantial single nodule
A single thyroid nodule with a hot nodule on nuclear scan is less likely to become cancerous and can be treated with thyroxine suppression therapy or nuclear therapy first. Cold nodules mostly require surgery. If a single nodule with fast development and hard texture, or a single nodule with enlarged lymph nodes in the neck or in children, it should be operated early because of its high possibility of malignancy.
2.Multi-nodular goiter
Traditionally, it is believed that MNG has less chance of developing cancer than single nodules. However, high-resolution ultrasonography has revealed that many people diagnosed as having a single nodule are actually having multiple nodules, and it is now believed that there is little difference in the incidence of cancer between the two. Therefore, the first step in the management of MNG is to rule out malignancy. If sTSH is decreased, hyperthyroidism is indicated. If FNA cytology is diagnosed as malignant or suspected malignant, it should be treated surgically.
3.Benign or malignant degenerative cysts
Cysts can be formed by either malignant degeneration. Pure thyroid cysts are rare, and any persistent or recurrent mixed masses should be removed.
4.Nodules that cannot be felt
In recent years, due to the development of ultrasound, CT, and MRI, small, non-palpable thyroid nodules can be found unexpectedly during other examinations. If the nodule is smaller than 37,5px, it only needs to be followed up and observed. If the nodule is larger than 37,5px, FNA can be done under the guidance of ultrasound, and then further treatment can be done according to cytological results.
5.Radiation nodules
Head and neck radiotherapy patients are prone to develop thyroid cancer as early as 5 years after radiation and as late as 30 years after radiation. FNA should be performed to confirm the diagnosis of thyroid nodules after radiation therapy.