September 30, 2022

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Diagnosis and treatment of thyroid nodules

Diagnosis and treatment of thyroid nodules

Diagnosis and treatment of thyroid nodules.  What is a thyroid nodule? The expert explained the related problems of thyroid nodules.

Diagnosis and treatment of thyroid nodules
women with thyroid gland problem on the blue background

1. What is a thyroid nodule?

The thyroid gland is located directly in front of the human body’s neck, below the laryngeal knot, and has the function of secreting thyroid hormone. Thyroid nodules are masses in the thyroid gland, which are common clinically. It can be caused by a variety of causes, such as thyroid degeneration, inflammation, autoimmunity, etc., which can all appear as nodules. Thyroid nodules can be single or multiple. Nodules can be benign or malignant, and most of them are benign. Most patients only need follow-up observation, some may require medication or surgery.

2. Why do I get thyroid nodules?

Thyroid nodules can be caused by many causes. Excessive or low iodine intake, thyroid hormone synthase deficiency, etc. may lead to hyperplastic nodular goiter. Neoplastic nodules include benign thyroid tumors, thyroid papilloma, follicular cell carcinoma, medullary thyroid carcinoma, undifferentiated carcinoma, lymphoma and other thyroid malignant tumors and metastatic carcinomas. Acute and chronic thyroid inflammation such as Hashimoto’s thyroiditis can also form thyroid nodules. In addition, thyroid cysts after excessive proliferation of normal tissues and degeneration of thyroid adenomas can also appear as nodules.

3. What are the symptoms of thyroid nodules?

The thyroid nodules in most patients do not have any symptoms and are only discovered incidentally during palpation or examination. Symptoms may occur when nodules gradually increase in size or have hormone secretion functions. Some patients present with pain around the nodules and a foreign body sensation in the pharynx. When the nodules compress the surrounding tissues, symptoms such as hoarseness, difficulty swallowing, and breathing difficulties may occur. Accompanied by hyperthyroidism, it may manifest as palpitations, sweating, and weight loss.

4. Are the thyroid nodules serious?

Most thyroid nodules are asymptomatic and do not need treatment, just regular review and observation. However, if the thyroid nodule is large or grows rapidly, and the patient has symptoms such as hoarseness and difficulty breathing, it needs to be treated in time. Especially malignant thyroid nodules usually require surgical treatment, and long-term medication is required after the operation. Sometimes patients may also be accompanied by other thyroid diseases, such as hyperthyroidism, at this time also need to seek medical treatment in time.

5. What examinations are needed for thyroid nodules?

Ultrasound is the first choice for thyroid nodules, which can determine the location, size and nature of the nodules. After the thyroid nodules are found, a serological thyroid function test is required to find whether there is hyperthyroidism or hypothyroidism. Fine-needle aspiration cytology is currently the most reliable method to determine benign and malignant nodules. Some cells are extracted from thyroid nodules for pathological examination to determine the pathological type. In addition, sometimes doctors will suggest that patients undergo a radionuclide scan to more accurately assess whether the nodule has secretory function.

6. How to treat thyroid nodules?

For most patients with no obvious symptoms, regular review is required, and if there is no obvious change, no therapeutic intervention is required. Symptomatic thyroid nodules may require treatment, which mainly includes medications such as antithyroid drugs, radiotherapy, and surgery. Especially for malignant nodules, the conventional treatment is surgical resection.

7. Do thyroid nodules have to undergo surgery?

Most thyroid nodules do not require surgery. For benign thyroid nodules, surgery is recommended only when the volume increases and oppresses surrounding tissues and organs, causing obvious symptoms such as dysphagia, hoarseness, and dyspnea. For malignant nodules, surgical removal is required in most cases.

8. What are the methods of surgical treatment?

The resection site of malignant nodules includes not only the nodules, but also part or all of the surrounding thyroid gland. Total thyroidectomy requires removal of the entire thyroid, complete removal of the lesion and low risk of recurrence, but it may damage peripheral nerves or tissues, and requires long-term thyroxine replacement therapy after surgery. Thyroid lobectomy only removes the diseased tissue, leaving one side of the normal gland, with less damage, and is suitable for most benign lesions and some early malignant lesions. In recent years, a new type of treatment-microwave ablation, is a minimally invasive treatment, mainly suitable for benign nodules.

9. What is microwave ablation of thyroid nodules?

Thyroid microwave ablation is a minimally invasive treatment, and benign nodules of the thyroid can be treated with this method. Usually only local anesthesia is needed. Under the guidance of color ultrasound, the location of the lesion and the distance from the skin are clarified, and the probe is slowly punctured into the lesion for thermal ablation, so as to achieve the purpose of disappearing nodules. The surgical trauma is minimal and the postoperative recovery is quick.

10. Does the thyroid node save energy and heal itself?

Thyroid nodules cannot heal on their own. Most thyroid nodules are asymptomatic, and small benign nodules that do not affect the life of the patient do not require special treatment. Intervention is needed when the nodules are large and produce symptoms. Some nodules may increase rapidly in a short period of time, suggesting the possibility of malignancy, even less likely to heal themselves, and prompt surgical treatment is required.

11. What should I pay attention to in daily life?

Patients should avoid excessive emotional excitement and affect the level of thyroid hormones. Keep a proper amount of iodine intake. Foods such as iodized salt and kelp have relatively high iodine content. Especially for patients with hyperthyroidism, limit the intake of iodine to avoid affecting the treatment of antithyroid drugs. Usually try to avoid exposure to radioactive sources and avoid taking weight-loss drugs and other drugs that affect metabolism.

(source:internet, reference only)


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