Thyroid Nodules

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The thyroid gland is located in the neck, below the voice box (larynx). The small, two-inch gland consists of two lobes, one on each side of the windpipe, connected by tissue called the isthmus. The thyroid gland plays an important role in regulating the body's metabolism

Basic facts about thyroid nodules

“Goiter” is a general term we use for an enlarged thyroid gland. This enlargement can be “diffuse,” meaning the entire gland is enlarged, or “nodular.” A thyroid nodule is a small lump, or a localized growth in the thyroid gland. An enlarged thyroid gland (diffuse goiter) may also contain one or more nodules. Thyroid nodules can be very small, less than a centimeter, or as large as several centimeters. They can occur singly or in groups of different sizes in the same gland. The cause of the nodules needs to be determined.

What causes a nodule?

Between 90-95% of all nodules are not cancerous overgrowths of thyroid tissue. Only about 5% are cancerous. To make sure that a nodule is not cancerous, all nodules should be properly evaluated.

What are the symptoms of a thyroid nodule?

A thyroid nodule usually has no symptom. Sometimes, it can press against the neck and cause a sensation of a lump in the throat. It can also produce difficulty in swallowing, hoarseness, or cough.

How common are nodules in the thyroid?

Less than 10% of the population have a nodule that is large enough to be felt by a physician. They are more common in women than men and the incidence increases with age. About 4% of women aged 20 years have a palpable nodule whereas 9% of women over age 70 have a palpable nodule. Nodules are only found in about 1% of men.

Diagnosing thyroid nodules

Thyroid nodules can sometimes be seen as lumps in the neck or can be felt by touching the neck. If you have a nodule, you should have it evaluated by a physician trained in the diagnosis and management of thyroid nodules.

Blood tests of thyroid function should be done to see if the thyroid gland is producing normal amount of thyroid hormones.

Ultrasound imaging of the thyroid can confirm the presence of thyroid nodules and their structures.

Radioactive iodine scanning can indicate whether a nodule is functioning or non-functioning. Almost all thyroid cancers occur in nodules that are non-functioning.

Fine-needle aspiration can help determine whether the thyroid nodules is benign or malignant.

How is a nodule treated?

The treatment of a nodule depends upon its cause. If the fine needle aspirate of your thyroid nodules shows non-cancerous cells, the nodules may just be monitored to make sure that it does not grow larger. You may also be advised to take thyroid hormone to suppress the activity of the gland and to prevent the further growth of the nodule. If the fine needle biopsy is suspicious for cancer, then surgical removal is recommended.

Excerpt from The Thyroid Gland: Thyroid Nodules by the Philippine Society of Endocrinology and Metabolism.