With the change of environment and lifestyle, the popularization of health examination, the wide application of advanced diagnostic technologies such as ultrasound and imaging, the detection rate of thyroid nodules has significantly increased. The incidence rate of thyroid nodules in adults is up to 80% or more. Thyroid enlargement and thyroid nodules are often misdiagnosed as thyroid cancer and are removed surgically. Below is a popular science knowledge about thyroid nodules, hoping to have a correct understanding of thyroid diseases.
1、 What is thyroid nodule?
The so-called thyroid nodule refers to a lump in the thyroid gland that can move up and down with swallowing movements. It can be caused by various factors, such as thyroid degeneration, various inflammations, autoimmune disease hyperplasia, benign adenoma, malignant tumor (cancer), and can present as a single or multiple nodular mass, or even unilateral or bilateral diffuse thyroid enlargement with nodules.
2、 The main causes of thyroid nodules
1. Hyperplasia and nodular goiter
Excessive iodine intake, especially in coastal areas where long-term residence, long-term iodized salt diet habits, excessive intake of substances or drugs that cause thyroid nodules, congenital thyroid hormone synthase deficiency, etc., lead to the highest incidence of hypertrophic thyroid nodules, while in iodine deficient areas, diffuse goiter (thick neck disease) is more common.
2. Inflammatory thyroid nodules
Acute suppurative thyroiditis (bacterial), subacute thyroiditis (viral infection), chronic lymphocytic thyroiditis (autoimmune), and other thyroid nodules caused by thyroid tuberculosis, syphilis, parasitic diseases can also be seen.
3. Tumor thyroid nodules are classified as benign thyroid tumors (i.e. thyroid adenomas, accounting for the vast majority); Thyroid malignant tumors (thyroid cancer), such as papillary thyroid carcinoma, follicular cell thyroid carcinoma, medullary thyroid carcinoma, undifferentiated carcinoma, lymphoma, and metastatic carcinoma. Among them, medullary thyroid carcinoma has the highest degree of malignancy, while papillary thyroid carcinoma has the lowest degree of malignancy, rarely metastasizes, and life-threatening cases are rare.
4. Thyroid cysts, thyroid nodular goiter, old hemorrhagic cystic and degenerative changes in adenomas, fluid accumulation (mostly benign), cystic changes in thyroid cancer, congenital thyrohyoid cysts, and cystic hematomas in thyroid trauma.
3、 How to treat thyroid nodules
1. Most benign nodules do not require surgical treatment. Regular follow-up thyroid ultrasound and monitoring of thyroid function can be performed, and if necessary, traditional Chinese medicine can be used for adjustment;
2. Those who meet one of the following conditions should go to the thyroid surgery department as soon as possible to evaluate whether surgical treatment is needed:
A. Those who experience persistent local compression symptoms such as hoarseness, swallowing difficulties, or breathing difficulties that are significantly related to nodules;
B. Patients with concomitant hyperthyroidism;
C. Ultrasound or neck CT suggest that the thyroid mass is located behind the sternum or in the mediastinum;
D. Ultrasound examination suggests the possibility of malignant transformation;
E. Nodules that have failed internal medicine treatment and grow rapidly in a short period of time;
F. Those who experience excessive mental stress due to nodules, which affects their normal life.
Thyroid nodules, with postoperative pathological diagnosis of malignant thyroid tumors accounting for about 5% -8%, while benign nodules such as thyroid adenomas, thyroid hyperplasia, bacterial or viral inflammation, especially autoimmune thyroiditis, account for more than 90%. Most of these benign thyroid nodules that grow slowly, have no compression symptoms, and function normally do not require surgical resection or other thyroid destructive treatments. Just need regular follow-up, B-ultrasound examination, thyroid function, autoantibody monitoring, etc.