NODULAR GOITR
Abnormal tissue growths in the thyroid gland, which have a different structure from the normal thyroid tissue, or may be in the size of chickpeas, chickpeas, and sometimes walnuts or oranges, are called nodules. The disease is called “nodular goiter” because most of the time the thyroid gland enlarges with the nodules. The size of the nodule differs from person to person. For example, the nodule may be very small, 3-4 millimeters in diameter, or the size of a walnut or even a large potato. A person may have only one nodule or more than one nodule. The presence of more than one nodule in the thyroid gland is defined as “multinodular goiter”. Depending on the neck structure, nodules that are usually one centimeter or more than one centimeter can be detected by the doctor during the examination.
How to Detect Nodule?
The nodule in the thyroid gland can be noticed by the patient himself, or it can be detected during the examination of the doctor he has gone to. In addition, a large nodule in the thyroid gland can be noticed when ultrasonography is performed on the neck of the patient for various complaints or when a chest X-ray is taken.
How Common is Thyroid Nodule:
Community studies have shown that a nodule of one centimeter or more than one centimeter in the thyroid gland can be palpated during examination, in one out of every 100 people in men, and in five out of every 100 people in women. However, when ultrasonography is performed on the thyroid gland, the detection rate of the nodule rises to 20% to 70%. Because the thyroid gland is a deep organ. It is also possible to detect nodules behind the thyroid that cannot be detected in manual examination by ultrasonography and to obtain information about the size of the detected nodule. On the other hand, if the nodule is one centimeter or more than one centimeter, it can be palpated during the examination. Ultrasonography, on the other hand, helps us to detect very small nodules under a centimeter. In short, “ultrasonography” is a more reliable diagnostic method for the evaluation of the thyroid gland for nodules
Thyroid Nodules Increase with Age.
Thyroid nodules increase with age. While the incidence of nodules is 20-25% between the ages of 18-65, this rate rises to 35-40% in those over 65 years of age. r; first of all, it should be evaluated by an endocrinology and metabolic diseases specialist
Why should nodular goiter be considered?
The importance of a nodule for the patient and the doctor is to learn whether the nodule is “cancer or not”. The second important point is to determine whether the nodule has excessive hormone secretion. The third important point is how to treat or monitor the nodule. Thyroid nodules started to be seen more frequently, especially after ultrasonography was used frequently in the neck. By examining the thyroid gland with ultrasonography or Doppler ultrasonography, it is possible to detect smaller nodules.
What are the Findings of Thyroid Cancer?
Thyroid cancers often do not cause symptoms or complaints in patients. Thyroid cancer is diagnosed as a result of recognizing the nodule, which is usually located in the thyroid gland, and performing some further tests on this nodule.
How Do You Diagnose?
Ultrasonography and/or Doppler ultrasonography are very helpful in the evaluation of thyroid nodule for cancer. During the examination of the thyroid gland or when a nodule of one centimeter or larger than one centimeter is detected by ultrasonography, a “thyroid scintigraphy” should be taken. In this way, the cold, hot and warm separation of the nodule is made. About 70-80% of the nodules are cold nodules, 10% are hot nodules, and 10% are warm nodules. The cancer rate is slightly higher in cold nodules, and the incidence of cancer varies between 5% and 10%. Cancer rate is much lower in hot nodule. Although ultrasonography gives us information to distinguish whether the nodule is benign or malignant, the best and most reliable information is obtained by performing a fine needle biopsy from the nodule itself.
Is Biopsy a Painful and Painful Procedure?
It is done to understand whether the nodule detected in the thyroid gland carries a cancer risk. According to the biopsy result, it is an examination that must be done because the decision to follow up with drug therapy or surgery will be made. It is a very simple, easy to do and painless examination since it is performed using an extremely small needle tip. Therefore, the patient does not need to be anesthetized during the biopsy. Cell groups are taken from the nodule in the thyroid gland as if blood is taken from a vein. The cells taken are examined in the pathology department to determine whether the nodule is benign, cancerous or inflamed. Biopsy is an easy procedure and one should not be afraid of the biopsy procedure.
Biopsy is not an operation, it does not matter whether the patient is hungry or full during the biopsy. Sometimes, not enough pieces or cells may be found with the biopsy. Then it is necessary to repeat the biopsy 2-3 months later at the earliest.
Experienced pathologists (cytologists) are needed in order to interpret the biopsy well. The result can be announced in a day or two. However, fine needle biopsy is insufficient to evaluate whether follicular cancer or Huthle-cell cancers are malignant or benign. Therefore, in such cases, the operation should be considered predominantly.
Which Nodules Are Suspected Cancer?
If the nodule grows rapidly despite the treatment, if there is abnormal growth in the lymph nodes in the neck region, if the nodule itself is very hard and adherent, if the voice is thickened or hoarse, if the patient’s first degree relative has thyroid cancer, the patient’s age is 20′ If it is below or above 60, it is necessary to be careful in terms of thyroid cancer. On the other hand, if there are clues that may suggest cancer in the ultrasonography or cancer cells or cells suspicious for cancer are found in the thyroid fine needle biopsy, surgery should be considered in the treatment. The fact that the operation is performed by experienced surgeons is an important factor that reduces the risk of complications related to the operation. Even if cancer is not detected in the post-operative pathological evaluation of a person who has undergone thyroid surgery, that person must use thyroid hormone for life and periodically take medication under the control of a doctor. On the other hand, people who are diagnosed with thyroid cancer should regularly use drugs (thyroid hormone) throughout their lives, and have their blood and/or imaging tests done periodically, in line with the recommendations of the endocrinology and metabolic diseases specialist who treats them.
