Thyroid nodules. Diagnostics and treatment

Thyroid nodules. Diagnostics and treatment

In assessing node in neck one of the main goals is to eliminate thyroid cancer (cancer of the thyroid gland). But an expert doctor must also determine whether the thyroid gland is functioning normally.


Studies include:

Medical examination. Typically, doctor asks to swallow anything during the inspection of the thyroid gland because the thyroid nodule moves up and down during swallowing.


Thyroid function. Tests that measure blood levels of thyroxine and triiodothyronine, hormones produced by the thyroid gland and thyroid stimulating hormone (TSH), secreted by the pituitary will help determine whether the thyroid gland produces too much thyroxine (hyperthyroidism) or too little (hypothyroidism).


Ultrasound. This imaging technique uses high-frequency sound waves and no radiation for imaging. This provides better information about the shape and structure of the nodules and can be used to differentiate cysts of hard nodules, to determine how many nodules present. Ultrasound is also used as a control of fine-needle aspiration biopsy.


Fine-needle aspiration (FNA) biopsy. This procedure is used to exclude malignant process. FNA helps to distinguish between benign and malignant thyroid nodules. During the procedure doctor inserts a very thin needle into the nodule and removes a sample of cells. The procedure is performed in a doctor’s office and takes about 20 minutes. The samples taken are sent to a laboratory and analyzed under the microscope.


Thyroid scan. During this test the inner side of the vein at the elbow, or sometimes in an arm vein, injected radioisotope. Then a special camera creates an image of your thyroid on a computer screen.


The time required for the procedure may vary depending on how long to achieve isotope moving thyroid. In the neck may feel some discomfort.


Nodules that produce excess thyroid hormone (hot nodules) appear on the screen bright spots, as they absorb the isotope more than the usual thyroid tissue. Cold nodules are not active and have a form of holes or defects during scanning. Hot nodules are almost always benign while some cold nodules are malignant. Thyroid scan method does not determine the benign or malignant cold nodules. For this a biopsy is necessary.


Scan time varies depending on how long the isotope is absorbed by the thyroid gland.


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Thyroid nodules treatment

Treatment depends on the type of thyroid nodule. If nodule is not cancerous, there are several treatment options:


Waiting. If the biopsy shows the presence of benign thyroid nodules doctor may suggest just watching, which usually means a physical inspection and testing of thyroid function on a regular basis. May need another biopsy if the nodule is growing. If benign thyroid nodule remains unchanged, treatment may not be necessary at all.


Thyroid hormone suppression therapy. Includes treatment of benign nodes thyroxine synthetic form that is accepted in tablets. The idea is that the supply of additional thyroid hormone will signal the pituitary to produce less TSH, a hormone that stimulates the growth of thyroid tissue.


Surgery. Sometimes the presence of a clearly benign nodule may require surgery, especially if it’s so big that difficult swallowing and breathing. Operation can also be recommended for people with a large multinodular goiter, especially when crop narrows the airways, esophagus or blood vessels. Nodules with indeterminate or suspicious diagnosis result on biopsy are also subject to surgical removal.


If the thyroid nodule produces thyroid hormones, overloading normal level of production of the thyroid hormone, doctor may recommend treatment of hyperthyroidism.

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