Should thyroid nodules be punctured?

Written by Hu Jian Zhuo

Nephrology and Endocrinology

Updated on September 18, 2024

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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

1min 10sec

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"Malignant thyroid nodules" means what?

Thyroid nodules are assessed under ultrasound with a grading system, and if rated at level three or higher, they tend to be more likely to be malignant. The most common malignancy in thyroid nodules is thyroid cancer. Among all types of tumors, thyroid cancer tends to grow slowly and is relatively less malignant. Therefore, if an ultrasound suggests a high likelihood of malignancy in a thyroid nodule, further examinations should be conducted. This can include a fine needle aspiration biopsy, thyroid contrast-enhanced ultrasound, or even direct surgical removal of the malignant nodule for further pathological examination to determine whether it is benign or malignant. Since the degree of malignancy of thyroid nodules is relatively low compared to other malignant tumors, a high grading score on a thyroid nodule should not be overly worrying. It is advisable to proceed with formal medical checks and regular follow-ups, as the five-year survival rate is quite high, exceeding 80%.

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Written by Hu Jian Zhuo

Nephrology and Endocrinology

1min 25sec

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Differentiation between benign and malignant thyroid nodules

Generally speaking, whether benign or malignant, thyroid nodules show blood flow signals. For benign nodules, blood flow signals can be seen around the perimeter, with internal blood flow no different from normal thyroid tissue. In such cases, the nodules are typically diagnosed as thyroid adenomas, and they usually appear round or oval in shape with a uniformly echoic internal substance. If liquefaction occurs, mixed or cystic changes can appear; the tumor’s capsule tends to be intact, with clear boundaries. If a nodule has abundant internal blood flow with disorganized vessel distribution and high flow velocity, showing a high-resistance flow pattern, and has relatively less peripheral blood flow, it generally needs to be assessed for thyroid cancer. These nodules are often hypoechoic with irregular shapes, and the ratio of their longitudinal to transverse diameter is greater than 1. They have unclear boundaries, lack a capsule, and have no halo. In typical cases, microcalcifications like sand grains can also be observed. From the above analysis, we can see that the blood flow signals in thyroid nodules are complicated and reflect the extent of the nodular pathology. These signals can help in differentiating benign from malignant nodules, but when a rich and disorganized blood flow is observed, the nodule is more likely to be malignant.

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Written by Hu Jian Zhuo

Nephrology and Endocrinology

38sec

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What is a thyroid nodule?

The thyroid is an endocrine gland located in the neck of the human body. If some abnormal nodules appear in it, they are referred to as thyroid nodules. Based on histological classification, they can be divided into follicular type, papillary type, and mixed type. A common characteristic of these types is that they generally appear as solitary nodules with a relatively complete capsule; the tumor cells differ from the surrounding thyroid tissue; and the cellular structure inside the tumor is relatively consistent. Generally speaking, middle-aged women are the demographic most prone to developing thyroid nodules.

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Written by Hu Jian Zhuo

Nephrology and Endocrinology

1min 8sec

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What should I eat for thyroid nodules to dissipate?

Traditional Chinese Medicine (TCM) believes that thyroid nodules are mainly caused by emotional distress, dietary imbalances, and environmental maladjustment. Long-term emotions such as anger and depression can lead to stagnation of qi (vital energy), resulting in liver qi dysfunction and the formation of phlegm. Qi stagnation and phlegm accumulation in the front of the neck lead to the formation of this goiter. Therefore, the treatment for this condition often involves the use of foods or medications that soften hardness, disperse nodules, reduce swelling, and resolve stasis. For example, purslane, loofah, plums, and dried figs are some of the foods that can clear heat, facilitate diuresis, reduce swelling, and disperse nodules. Appropriate consumption of these foods can be beneficial in slowing the progression of the disease. However, it is generally difficult to dissolve nodules through diet alone, and active treatment is still necessary.

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Written by Li Jin Quan

General Surgery

36sec

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How to deal with calcification of thyroid nodules?

Thyroid nodules calcification can be divided into coarse calcification and microcalcification. Coarse calcification is generally benign, and benign conditions do not require special treatment. When a large nodule causes compression symptoms and affects our appearance, surgical removal can be considered. Microcalcification is mostly likely to become malignant, therefore, cytological biopsy of the thyroid should be performed. If it is benign, we can continue to observe it. If it is malignant, we can treat it with surgery, comprehensive therapy, or radiotherapy.