Professional Documents
Culture Documents
OF THYROID
LUMPS
Thyroid Gland
Thyroid Lump
Mass in front of the neck
Due to enlargement of thyroid gland
Known as Goiter
Can be
1- Diffuse
2- Nodular
Simple diffuse
Auto-immune
Thyroiditis
Iodine deficiency
Goitrogens
Dyshormogenesis
Nodular:
Solitary
Multi-nodular
Cystic
Fibrotic
Tumours:
Adenomas
Carcinomas
Lymphomas
Miscellenous:
Sarcoidosis
Tuberculosis
Symptoms
Swelling in the neck:
Small or large
Asymptomatic or painful
May compress nearby structures and cause:
Airway obstruction
Dysphagia
Coughing or wheezing
Hoarseness of voice
History
The patient may present with :
Swelling in the neck:
Seen by the patient or on routine physical exam
Referred as an incidental nodule on imaging
Age
Dysphagia, stridor, hoarseness
Pain
Change in size of the lump
Symptoms of hypothyroidism or hyperthyroidism
History of previous radiation
Family history of thyroid cancer
Examination
Inspection
Palpation
Percussion
Auscultation
Blood Tests
THYROID FUNCTION TEST:
Functional status of thyroid gland
Euthyroidism, hypothyroidism or hyperthyroidism
Measure serum TSH, free T3 and T4
T3
Normal levels/Euthyroid
Primary Hypothyroidism
Secondary Hypothyroidism
Primary Hyperthyroidism
Secondary Hyperthyroidism
( 2.3-4.2 ng/dL)
T4
(0.8-2.8 ng/dL)
TSH
(0.3-5.0 U/mL )
Blood Tests
Serum Thyroglobulin:
Protein found in thyroid cells
Use: Follow up cases of thyroid Ca after surgery
Ref range: 0-30 ng/mL
Thyroglobulin Autoantibodies:
Serum Calcitonin:
Use: Suspected medullary carcinoma
nodule
Gold standard
High sensistivity/specificity- upto 90%
US guided FNAC/FNAB further inc. accuracy
Aspiration may be reported as:
i. Benign
ii. Malignant
iii. Suspicious
iv. Non diagnostic
FNAC
ULTRASOUND
Widely used imaging technique
Uses:
i.
ii.
iii.
iv.
v.
vi.
Medullary
carcinoma
Medullary
carcinoma
Thyroid Scan
Uses Tc99m, I123, I131
Functional status of nodule in relation to surrounding
tissues.
Can differentiate between:
(frequency)
(malignancy)
Hot (hyperfunctioning) nodules
Cold(hypofunctioning) nodules
5%
80%
10%
1%
X RAYS
CT SCAN/MRI
Imaging technique
Not as routine
Large goiter
Extent of retrosternal extension
assesing neck nodes
Tracheal compression
CT SCAN
MRI
THANKYOU