Treatment of Thyroid Nodules Flashcards
what divides the anterior and posterior triangle?
sternocleidomastoid
causes of midline neck lumps?
thyroid
thyroglossal cyst
dermoid cyst
questions to determine whether midline lump is related to thyroid?
does it move on swallowing
causes of anterior triangle swellings?
lymph nodes
branchial cyst
salivary glands
carotid body tumour
causes of posterior triangle sweeling?
lymph nodes
cystic fibroma
what do you look for in neck lumps?
position size shape mobility consistency lymph nodes
types of cervical lymphadenopathy?
infective
malignant
haematological (leukaemia/lymphoma)
symptoms of cervical lymphadenopathy?
fever, weight loss, sweats (systemic)
hoarseness, cough, dyspnoea (specific)
recent immigrant, travel abroad (background)
cause of node
what must you always look for in cervical lymphadenopathy?
look for other nodes
look for primary sites
look for hepatosplenomegaly
investigations for cervical lymphadenopathy?
CXR
ENT opinion
fine needle aspiration
when is CXR/biopsy/ENT used?
if only in neck and suspected primary
when is haematology used?
if more generalised
features of thyroglossal cyst?
arisesin part of thyroglossal tract
in young people
moves with swallowing and protrusion of tongue
what is a dermoid cyst?
abnormal growth containing epidermis, hair follicles, sebaceous glands and in some cases, teeth
derived from residual embryonic tissue
what is a branchial cyst?
persisting second branchial arch
arises in upper part of anterior triangle in teenage years
feels like a half filled hot water bottle
what is a cystic hygroma?
fluid filled sac due to blockage of lymphatic system usually in first year of life can be large and cause - pressure symptoms - lymph filled - transmilluminate
what can cause swelling of submandibular gland?
stone
pleomorphic adenoma
what can cause swelling of parotid gland?
infective
pleomorphic adenoma
stone
investigation of a solitary thyroid nodule?
onset, duration, progression
pressure symptoms - dysphagia, dyspnoea, hoarseness, weight loss
risk factors/red flags
age, sex, family history pf thyroid cancer, radiation, thyroiditis
female vs male with thyroid nodule?
male most likely to be a cancer
female more likely to be benign
investigations in STN?
TSH
US
isotope scan sometimes
classification of thyroid nodules?
bethseda system thy 1 = inadequate thy 2 = benign Thy 3 = suspicious Thy 4/5 = malignant
