Thyroid nodule examination checks what

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 26, 2024
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Generally, when thyroid nodules are detected, one should visit the hospital's breast and thyroid surgery department or the endocrinology department. If you find a thyroid nodule, you can consult a doctor and undergo some relevant tests based on your specific situation. Typically, the following tests are conducted: 1. Thyroid ultrasound: This can determine the size, number, location, texture, shape, and edges of the nodules, including whether there is calcification. It also examines the blood supply within the thyroid nodule, the relationship with surrounding tissues, and assesses whether there are lymph nodes in the neck and the nature of these lymph nodes. 2. Blood tests are needed to measure thyroid function, particularly the level of Thyroid Stimulating Hormone (TSH). Higher levels of TSH indicate that the thyroid nodule is more likely to be proliferative, and thus, the risk of thyroid cancer increases. In addition, Thyroglobulin (Tg) can be measured. Another measure is Serum Calcitonin (Ct). If serum calcitonin is > 100 pg/mL, medullary thyroid cancer should be highly considered, as these cancer cells can secrete large amounts of serum calcitonin, causing this marker to significantly increase. Nuclear isotope imaging is also performed. If the nodule is large and TSH levels are low, a thyroid radionuclide scan is conducted to see if the nodule is a hyperfunctioning adenoma. When necessary, a Fine Needle Aspiration Biopsy (FNAB) is also performed. Fine needle aspiration is an invasive test, but it is currently an important and most efficient method to assess the benign or malignant nature of the nodule. It is generally performed under ultrasound guidance.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Should thyroid nodules be punctured?

Thyroid fine needle aspiration is a reliable and highly valuable diagnostic method we use to distinguish between benign and malignant thyroid nodules. Generally, thyroid nodules with a diameter >1 cm are considered for fine needle aspiration. Fine needle aspiration is not routinely considered in the following situations: (1) The nodule has already been evaluated with a nuclear scan indicating a hyperfunctioning adenoma due to hyperthyroidism; (2) The nodule is purely cystic; (3) The nodule is highly suspected to be highly malignant. In cases where the nodules grow rapidly and significantly enlarge, causing compression of the surrounding trachea and symptoms such as breathing difficulties and hoarseness, these thyroid nodules requiring surgery do not necessitate further fine needle aspiration treatment.

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Written by Zhang Jun Jun
Endocrinology
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The difference between thyroid nodules and nodular goiter

Thyroid nodules are the clinical manifestations of nodular goiter, and nodular goiter is the cause of thyroid nodules. Nodular goiter generally occurs in iodine-deficient areas, forming these partial or multiple thyroid nodules. Thyroid nodules are the clinical manifestations of nodular goiter; the nodules in the thyroid can be single or multiple and can cause abnormal thyroid function, although thyroid function can also be normal in the early stages. Therefore, when performing an ultrasound, if thyroid nodules are discovered, it is necessary to further assess thyroid function and dynamically track changes in the size of the thyroid nodules to determine whether it is nodular goiter.

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Written by Li Jin Quan
General Surgery
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Diet for thyroid nodules calcification

Patients with calcified thyroid nodules need to be cautious about their diet. Firstly, they should avoid irritating foods such as chili peppers, ginger, garlic, strong tea, coffee, and alcohol. Secondly, they should not consume foods high in fiber as these can cause diarrhea. Instead, they should eat foods rich in carbohydrates and fats, which provide energy and reduce the consumption of proteins in the body, as proteins play an important role in physiological regulation. Additionally, these patients should consume foods rich in vitamins and minerals to aid physiological metabolism. Lastly, it is beneficial for patients with calcified thyroid nodules to include animal organs in their diet.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Probability of thyroid nodules becoming cancerous

The malignant manifestation of thyroid nodules is thyroid cancer. Thus, thyroid nodules are divided into two major categories: benign and malignant. Benign nodules generally make up the vast majority, with malignancies accounting for less than 5%. Malignant thyroid nodules are cancerous. Some benign thyroid nodules may also become malignant over time. Generally, small nodules do not show obvious clinical symptoms during the cancerous transformation, but their nature changes. When a nodule compresses surrounding tissues and causes certain symptoms, such as hoarseness, tracheal compression, and difficulty swallowing, it often indicates that the tumor is in the middle or late stage. Overall, the chances of benign nodules becoming cancerous are very small. The malignancy rate of benign nodular goiter is about 5%, and the possibility of adenomas turning malignant is around 10%. As the diameter increases, the possibility of adenomas becoming malignant gradually increases. There are several high-risk factors for the malignant transformation of thyroid nodules: for instance, having a history of radiation exposure to the head and neck area during childhood or adolescence, patients who are younger than 14 or older than 70; the rate of malignant transformation of thyroid nodules significantly increases; and the rate of malignant transformation in male nodules is significantly higher than in females. Also, patients whose nodules significantly increase in size in a short period during regular check-ups are also considered high-risk for malignancy.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid nodule biopsy pros and cons

Currently, thyroid nodule puncture is performed under ultrasound guidance, so it is relatively safe. Fine needle aspiration causes minimal damage to the thyroid and almost no complications occur. Generally speaking, the following few adverse reactions may occur: One is bleeding, because the thyroid is a blood-rich organ, so bleeding may occur post-puncture. It can be controlled by applying local pressure immediately after the puncture. The second is pain, which is generally mild and can be relieved within 1-2 days. The third is skin infection, which is more likely in patients who are obese, have numerous skin folds, and sweat easily. In such cases, antibiotic treatment may be necessary. The fourth is injury to the trachea and nerves, although this is very unlikely and typically resolves on its own.