Thyroid Nodules Quick Questions and Answers

This is the 4986th article of Da Yi Xiao Hu

ask

What are thyroid nodules?

A: The thyroid gland is located on both sides of the larynx and trachea. Thyroid nodules refer to lumps in the thyroid gland and are the most common manifestation of thyroid disease. Since thyroid nodules have no obvious symptoms in the early stages, most people discover their thyroid nodules during physical examinations.

ask

Are thyroid nodules common?

A: Thyroid nodules are very common. Generally, the detection rate of thyroid nodules by specialists is 3% to 7% through palpation; with the help of thyroid ultrasound, the detection rate of thyroid nodules can be as high as 20% to 76%. Women are more likely to develop thyroid nodules than men.

ask

What are the common symptoms of thyroid nodules?

A: Most patients with thyroid nodules do not have obvious physical discomfort or clinical symptoms. They are found accidentally during physical examinations or other medical consultations. If thyroid nodules are combined with other diseases, the following may occur:

When combined with hyperthyroidism, patients may experience symptoms such as panic, palpitations, insomnia, irritability, and exophthalmos;

When combined with hypothyroidism, patients will have symptoms such as fatigue, fear of cold, drowsiness, and depression.

If the nodule grows significantly and compresses the surrounding tissues, corresponding symptoms may also appear, such as difficulty breathing, difficulty swallowing, choking when drinking water, hoarseness, etc.

ask

How to determine whether a thyroid nodule is benign or malignant?

Answer: The most common examination for thyroid nodules is color Doppler ultrasound. Most nodules can be detected by color Doppler ultrasound, and a preliminary judgment can be made on whether the nodules are benign or malignant. Fine needle aspiration (FNAB) of the thyroid is the most reliable and valuable diagnostic method for distinguishing benign and malignant nodules. Generally speaking, FNAB can be considered for thyroid nodules with a diameter > 1 cm. Under the guidance of ultrasound images, a fine needle is used to puncture and extract some cells. The pathologist analyzes the morphology and differentiation of the extracted cells to confirm whether the nodule is benign or malignant.

ask

Is surgery necessary for thyroid nodules?

A: Not necessarily. If the nodule is malignant, surgery is usually required for removal. If it is benign, surgery is required in the following cases: nodule compression leading to breathing and swallowing difficulties; nodule continues to grow; nodule is located behind the sternum or in the mediastinum; combined with hyperthyroidism, ineffective medical treatment, and autonomous thyroid hyperfunctioning adenoma and toxic multinodular goiter.

ask

Which department should I visit for thyroid nodules?

A: Thyroid nodules can be treated by thyroid surgery, head and neck surgery, endocrinology, and general surgery. If surgery is required, thyroid surgery, head and neck surgery, and general surgery will be the main treatment. If combined with hyperthyroidism or hypothyroidism, drug treatment is required, endocrinology will be the main treatment.

ask

Can thyroid nodules heal on their own?

A: Although thyroid nodules may sometimes shrink on their own, in most cases, once formed, they will not completely heal on their own. Most thyroid nodules do not cause symptoms, and if the benign nodules are small, they will not affect the patient's life. If the benign nodules are large, doctors need to intervene for treatment. If they are malignant nodules, timely surgical removal is usually recommended.

Author: Li Yujin, Shanghai Fifth People's Hospital, Fudan University