October 14, 2016

Thyroid Nodules

Thyroid Nodules

Thyroid nodules are simply a descriptive term for any lump in the thyroid gland. Thyroid nodules are relatively common, and may be first identified either by the patient or close friend/family member noticing a lump in the neck, by the patient’s healthcare provider on a routine physical exam, or by spotting the nodule on an imaging study (CT or MRI) that was originally performed for some other reason.

The thyroid is a gland located in the lower portion of the neck, just below your voice box. It is butterfly-shaped, with a lobe of tissue sitting on each side of the trachea (wind pipe) connected by a narrower isthmus resting on the front of the trachea. This gland secretes thyroxine (T4) and triiodothyronine (T3), collectively referred to as thyroid hormone, into the bloodstream. Thyroid hormone helps regulate metabolism in a variety of tissues throughout the body.

Thyroid nodules may be benign (most common) or cancerous (10% of nodules). Further evaluation of the nodule will be needed to determine which of these categories it belongs to. Generally, a thyroid ultrasound will be ordered as well as bloodwork to evaluate for an under- or overactive thyroid gland.

Nodules that are small or appear benign on ultrasound may be followed by obtaining another ultrasound several months later. Based on certain criteria on ultrasound, such as size of the nodule, consistency of the nodule (solid or fluid-filled), and presence of other findings like increased blood flow or presence of calcifications, a biopsy may be recommended. Typically a biopsy will first involve a minor procedure known as ultrasound-guided fine needle aspiration. This procedure allows a sampling of cells from the nodule for analysis. The biopsy may show the nodule to be benign, malignant, or varying degrees of abnormal in between. In some cases, additional genetic testing on a needle biopsy can be performed to help predict how likely the nodule is to be cancerous. This additional testing can be useful in cases when the initial biopsy is reported as abnormal, but not definitely cancerous.

If a thyroid nodule is thought to have a high likelihood of being cancerous, or if the nodule is large enough to cause symptoms, surgery to remove part or all of the thyroid gland may be recommended.

The physicians at Peak ENT are experienced in managing thyroid nodules and performing thyroid surgery, and will guide you through every step in the diagnosis and decision making process.