Thyroid Nodules

Question 1

Define

Answer 1

DEFINITION: abnormal growth of thyroid cells that forms a lump in the thyroid gland.

Question 2

Causes

Answer 2

The vast majority of thyroid nodules are BENIGN, but a small proportion turn into thyroid cancer

Most thyroid nodules are adenomatous and most are multiple

The nodules are usually non-functioning

Question 3

Epidemiology

Answer 3

40% of the general population have a single nodule or multiple nodules

More common in WOMEN

Very small proportion of thyroid nodules will be malignant

Question 4

Symptoms

Answer 4

Most are ASYMPTOMATIC

Usually found on self-examination or clinical examination

A single isolated nodule is more likely to be malignant

They can sometimes cause pain and will rarely compress the trachea or cause dysphagia

Question 5

Signs

Answer 5

Ask the patient to drink some water and see if the nodule moves when swallowing

Check for regional lymphadenopathy (consider malignancy)

Question 6

Investigations

Answer 6

TFTs - most patients will be euthyroid

Ultrasound - useful for determining the character of the thyroid nodules

FNA - allows cytological analysis

Radionuclide Isotope Scanning - checks iodine uptake

CT/MRI - detect spread of thyroid cancer