How can thyroid tumor be detected?
Thyroid tumor is not difficult to be diagnosed by asking medical history, doing CT, ultrasound, thyroid isotope scan, thyroid function and other examinations, and if necessary, the diagnosis can be confirmed by puncture cytology examination. Since all kinds of examinations cannot completely exclude the possibility of thyroid cancer, it is recommended that patients with thyroid lumps should be operated as soon as possible so that the diagnosis can be clear and the lesion can be removed at the same time.
1.Ultrasound examination: Ultrasound can clarify whether the thyroid mass is cystic or substantial, and can also observe the blood flow in the mass, if there is rich blood flow in the thyroid tumor, there is a possibility of malignant transformation.
2. Measurement of thyroid 131 iodine uptake rate No matter benign or malignant tumor, thyroid 131 iodine uptake rate is mostly normal, but functional autonomous thyroid adenoma can be high.
3.Thyroid nuclear scan.
①Thermal nodules: mostly benign tumors, less likely to be thyroid cancer.
②Hot nodules: almost all are benign.
③Cold nodules: all thyroid cancers are cold nodules and their margins are usually fuzzy, but cold nodules are not always cancerous. In benign nodular goiter, degenerative changes often occur in the nodules due to poor blood circulation, forming cysts, which may also appear as cold nodules, although their edges are more clearly visible; while thyroid adenoma mostly appears as warm and cool nodules, but it can also be cold nodules.
4. Thyroid function tests are mostly normal in all functional indicators.
5.Neck x-ray examination: when the thyroid tumor is huge, the trachea can be seen to be compressed or displaced, and calcified images can be seen in some of the tumors.
6.Puncture cytology examination: it can further clarify the nature of thyroid nodules, and the diagnostic accuracy rate is more than 80%.
What are the causes of thyroid tumor?
Thyroid tumor is a common clinical disease and multi-infection, most of them are benign lesions, a few of them are cancer, sarcoma, malignant lymphoma, etc. The incidence of this disease is significantly higher in women than in men, and the incidence ratio of men to women is about 1:2 to 3.
The etiology of thyroid tumors is still unclear. Currently, there are two most discussed causes of differentiated thyroid cancer (including papillary carcinoma and follicular carcinoma): one is radiation and the other is endemic goiter.
What are the common thyroid tumors
Hashimoto’s thyroiditis is an autoimmune disease, mostly seen in women (95%), with a high prevalence between 30 and 60 years of age. It develops slowly and has a long course, and can be asymptomatic in the early stages, but by the time a goiter appears the disease has been present for 2 to 4 years. Many patients have no pharyngeal discomfort, and 10% to 20% have local pressure symptoms or vague pain in the thyroid area. The clinical picture is mostly one of diffuse bilateral symmetric enlargement of the thyroid gland; high titers of thyroglobulin and thyroid microsomal antibodies and normal or low thyroid hormones T3 and T4. The incidence of Hashimoto’s thyroiditis combined with thyroid cancer is 1% to 20%.
Goiter: It is common in women and the cause is not very clear. It may be related to iodine deficiency, smoking and genetic factors. Since the thyroid gland is located at the front of the neck, thyroid tumors tend to grow outward, so they are easily detected. Goiter presents as diffuse goiter in the early stage and nodule formation in the late stage. Goiter is usually painless, but pain can occur if there is bleeding in the nodule; when bleeding in the nodule capsule can aggravate dyspnea, if it presses on the esophagus causing difficulty in swallowing, and if it presses on the recurrent laryngeal nerve causing vocal cord paralysis, hoarseness or even difficulty in breathing. If thyroid nodules are found to be hard and inactive on physical examination, one should be alert to the possibility of malignant transformation, with a cancer rate of 5% to 10%.
Ultrasound of the neck is the most reliable way to determine goiter. ultrasound can detect small nodules of 2 to 4 mm, so ultrasound can detect nodules that cannot be touched by physical examination. Only 4% to 7% of thyroid nodules in adults are detected by physical examination, while nearly 70% are detected by ultrasound.
In general, thyroid function and serum T3 and T4 levels are normal in patients with nodular goiter. Serum thyrotropin (TSH) levels are the best indicator of thyroid function, and subclinical hyperthyroidism presents with decreased TSH levels.
Thyroid adenoma is most common in women aged 20-40 years old. The main reason for the onset of the disease is due to chronic anger or depression and sadness, followed by factors related to living environment (such as soil and water, diet) and physical condition. The disease usually has no obvious symptoms at the beginning, and is often detected by ultrasound during a physical examination. Thyroid adenoma is an oval-shaped, walnut-like lump confined to one place in front of the neck, mostly solitary, with smooth surface, tough texture and clear border, moving up and down with swallowing. When there is bleeding in the tumor, the mass can increase rapidly and be accompanied by local pain. These symptoms may disappear within 1 to 2 weeks. A few tumors with large size may have pressure symptoms, and the lymph nodes in the neck are usually not enlarged. In addition to hyperthyroidism, thyroid function is mostly normal. isotope scan is mostly cold nodules or cool nodules. ultrasound scan is a substantial mass, and those with intracapsular hemorrhage or cystic changes appear as cystic mass. Intra-tumor calcified spots are occasionally seen on neck x-ray.