A thyroid nodule is a lump in or on the thyroid gland. Thyroid nodules are detected in about 6 percent of women and percent of men; they occur 10 times as often in older individuals, but are usually not diagnosed. Any time a lump is discovered in thyroid tissue, the possibility of malignancy cancer must be considered. More than 95 percent of thyroid nodules are benign noncancerous , but tests are needed to determine if a nodule is cancerous.
Nodules can be caused by a simple overgrowth of normal thyroid tissue, fluid-filled cysts, inflammation thyroiditis or a tumor either benign or cancerous. Most nodules were surgically removed until the s. In retrospect, this approach led to many unnecessary operations, since fewer than 10 percent of the removed nodules proved to be cancerous. Most removed nodules could have simply been observed or treated medically. Chronic thyroiditis Hashimoto's disease is an inflammation of the thyroid gland that develops slowly.
It frequently leads to a decreased function of the thyroid hypothyroidism. Thyroiditis occurs when the body's immune system destroys the cells in the thyroid gland. Chronic thyroiditis is most common in women and people with a family history of thyroid disease. A thyroid fine needle biopsy is a simple procedure that can be performed in the physician's office. Some physicians numb the skin over the nodule prior to the biopsy, but it is not necessary to be put to sleep, and patients can usually return to work or home afterward with no ill effects.
This test provides information that no other test can offer short of surgery. A thyroid needle biopsy will provide sufficient information on which to base a treatment decision more than 85 percent of the time if an ultrasound is used.
Use of fine needle biopsy has drastically reduced the number of patients who have undergone unnecessary operations for benign nodules. However, about percent of biopsy specimens are interpreted as inconclusive or inadequate, that is, the pathologist cannot be certain whether the nodule is cancerous or benign. In such cases, a physician who is experienced with thyroid disease can use other criteria to make a decision about whether to operate.
A thyroid scan is a picture of the thyroid gland taken after a small dose of a radioactive isotope normally concentrated by thyroid cells has been injected or swallowed. The scan tells whether the nodule is hyperfunctioning a "hot" nodule. Because cancer is rarely found in hot nodules, a scan showing a hot nodule eliminates the need for fine needle biopsy. If a hot nodule causes hyperthyroidism, it can be treated with radioiodine or surgery. Neither a thyroid scan nor radioiodine treatment should ever be given to a pregnant woman.
Small amounts of radioactive iodine will be excreted in breast milk. Since radioiodine could permanently damage the infant's thyroid, breast-feeding is not allowed for women undergoing radioiodine treatment. In thyroid ultrasoundography, high-frequency sound waves pass through the skin and are reflected back to the machine to create detailed images of the thyroid.
It can visualize nodules as small as millimeters. Ultrasound distinguishes thyroid cysts fluid-filled nodules from solid nodules. Recent advances in ultrasonography helps physicians identify nodules which are more likely to be cancerous. Thyroid ultrasonography is also used for guidance of a fine needle for aspirating thyroid nodules.
Ultrasound guidance enables physicians to biopsy the nodule to obtain an adequate amount of material for interpretation. Even when a thyroid biopsy sample is reported as benign, the size of the nodule should be monitored.
A thyroid ultrasound examination provides an objective and precise method for detection of a change in the size of the nodule. A nodule with a benign biopsy that is stable or decreasing in size is unlikely to be malignant or require surgical treatment. Most patients who appear to have benign nodules require no specific treatment.
These tests are particularly helpful when the specimen evaluated by the pathologist is indeterminate. These specialized tests are done on samples obtained during the normal biopsy process. There are also specialized blood tests that can assist in the evaluation of thyroid nodules. These are currently available only at highly specialized medical centers, however, their availability is increasing rapidly. Ask your doctor if these tests are available and might be helpful for evaluating your thyroid nodule.
All thyroid nodules that are found to contain a thyroid cancer, or that are highly suspicious of containing a cancer, should be removed surgically by an experienced thyroid surgeon.
Most thyroid cancers are curable and rarely cause life-threatening problems see Thyroid Cancer brochure. Thyroid nodules that are benign by FNA or too small to biopsy should still be watched closely with ultrasound examination every 6 to 12 months and annual physical examination by your doctor.
Surgery may still be recommended even for a nodule that is benign by FNA if it continues to grow, or develops worrisome features on ultrasound over the course of follow up. For information on thyroid patient support organizations, please visit the Patient Support Links section on the ATA website at www. Thyroid Nodules. Thyroid Nodule FAQs. The important points to remember are the following: Thyroid nodules generally do not cause symptoms. Thyroid tests are most typically normal—even when cancer is present in a nodule.
The best way to find a thyroid nodule is to make sure your doctor checks your neck! The report of a thyroid fine needle biopsy will usually indicate one of the following findings: The nodule is benign noncancerous. This is even lower when the biopsy is reviewed by an experienced pathologist at a major medical center.
Generally, benign thyroid nodules do not need to be removed unless they are causing symptoms like choking or difficulty swallowing. Follow up ultrasound exams are important. Occasionally, another biopsy may be required in the future, especially if the nodule grows over time.
The nodule is malignant cancerous or suspicious for malignancy. These diagnoses require surgical removal of the thyroid after consultation with your endocrinologist and surgeon. The nodule is indeterminate. An Indeterminate finding means that even though an adequate number of cells was removed during the fine needle biopsy, examination with a microscope cannot reliably classify the result as benign or cancer. This information provides a general overview and may not apply to everyone.
Talk to your family doctor to find out if this information applies to you and to get more information on this subject. Hyperparathyroidism occurs in your parathyroid glands and results in the production of too much parathyroid hormone and a lack…. Hyperthyroidism is an overactive thyroid. It affects your heart rate, organ function, muscles,…. Hypothyroidism is an underactive thyroid. Your thyroid controls your metabolism, heart rate, muscles, bones, and other organs.
Visit The Symptom Checker. Read More. Abnormal Uterine Bleeding. Vaginal Discharge. Polycystic Ovary Syndrome. Alcohol Abuse. Home Diseases and Conditions Thyroid Nodules. Table of Contents.
What is a thyroid nodule? What causes thyroid nodules? How are thyroid nodules diagnosed? How can my doctor tell if I have a thyroid nodule that is cancerous? Can thyroid nodules be prevented or avoided? Thyroid nodule treatment Some patients who have small benign nodules may choose watchful waiting. Living with thyroid nodules Most people who have thyroid nodules lead a normal life.
Questions to ask your doctor Is my thyroid nodule cancer?
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