3 - thyroid nodules Flashcards
what are thyroid nodules?
nodule = growth of abnormal tissue
thyroid nodule when more than 1 cm and thyroid lesion when less than 1 cm
are most thyroid nodules benign or malignant?
95% benign (often seen on photos, no symptoms)
what neck symptoms could be for thyroid nodule?
- lump size
- pain
- soft or hard
- duration and growth rate
- voice change or stridor
- swallow affected?
- any other lumps
what are some risk factors for thyroid nodules?
- non-smoker
- female
- family history
- obesity
- pre-existing thyroid disease
what are some examinations done for thyroid?
- inspection & palpation (of triangles & lymph nodes)
- tongue extend out, if lump moves as stick out tongue then thyroglossal cyst
- drink water, thyroid moves when drink
- pemberton’s sign = arms up in air, face goes red or purple, problem with venous system
what blood tests done for thyroid nodule?
- TSH (reflects thyroid function)
- calcium (to exclude hyperparathyroid)
what is 1st line imaging for thyroid nodule? what other ones could be done?
ultrasound - then grade from U1-U5
1 = normal
2 = benign
3 = undetermined
4 = suspicious
5 - malignant
CT if voice change and radioisotope scan if TSH suppressed
what is FNAC and when would you do?
FNAC = fine needle aspiration cytology. done for thyroid if U5 or U3/4 that’s more than 1 cm
what are 3 reasons you would do thyridectomy?
- because toxic (graves toxic nodule or toxic multi-nodular)
- because compression symptoms like swallowing or breathing problems (when massive)
- because it’s cancer or it might be
what are 2 types of thyroidectomy and what to watch out for?
- lobar or hemithyroidectomy = take out 1 lobe
- total thyroidectomy
- watch out for damaging nerves or parathyroid glands
what is management of benign thyroid nodules?
only surgery if compressive symptoms
- ultrasound surveillance if small & low cancer risk
- can do thyroid ablation with radiofrequency etc
