The thyroid gland – it is the largest in the human body. A thyroid nodule is an area of tissue that differs in color or density from the rest of the thyroid tissue, which has clear boundaries. The thyroid gland, the nodes of which are normal, has the shape of a butterfly located on the thyroid cartilage of the larynx.
Nodules can appear anywhere in the thyroid gland. Some of them can be felt, others can form deep in the tissues or in the lower part of the gland, in which case it is very difficult to find them. Almost all thyroid diseases can accompany the formation of nodes. Most of the nodes are detected in a patient by chance as a result of ultrasound examination.
REASONS FOR THE APPEARANCE OF NODES IN THE THYROID GLAND
Most often, colloid proliferating goiter contributes to the development of nodes in 90% of cases. Less commonly, it is possible as a result of thyroid tumors:
- Benign tumors – 5-8%;
- Malignant tumors – 1-2%;
The causes of malignant and benign tumors are unknown. There is evidence that this is a hereditary predisposition, and also have effects of radiation to the neck and head. There is no consensus about the reasons for the development of colloid goiter. It is known that its prevalence increases with age, as a result of which nodular colloid goiter is considered as an age-related change in the thyroid gland. Scientists admit that iodine deficiency leads to its development.
WHAT ARE THE TYPES OF THYROID NODES AND WHAT ARE THEY ARE?
Depending on the composition, causes and origin of the nodular goiter, its following types are distinguished:
- Malignant education;
- Follicular adenoma;
- True cyst;
- Diffuse nodular goiter;
- Conglomerate nodular goiter;
- Multinodular goiter;
- Endemic nodular goiter.
5% of the population has single nodes, but most people do not even know about it. They are more dangerous than multinodular , because in this case, the risk of cancer is less. A single node usually refers to one of the following types:
- Malignant formations;
- Slow growing adenoma
- Benign degenerative tumor / adenoma;
- Colloidal proliferating goiter;
- A cyst containing fluid.
The examination usually determines:
- Isoechoic formations – their density corresponds to the density of the surrounding tissue;
- Inechoic stage – it is accompanied by increased blood circulation and vasodilation;
- A hypoechoic node is a seal filled with fluid or dead cells that occurs as a result of the destruction of organ tissue. May be a symptom of a cyst or tumor process;
- Colloidal node – consists of gland tissues, is detected with an intensive supply of blood to an organ site.
Types of echogenicity in ultrasound examination of the thyroid gland
Isoechoic nodes are homogeneous and heterogeneous. If the node is heterogeneous, with a pronounced or insignificant change in tissue, hypoechoic areas corresponding to cystic degeneration are found. They appear as a result of the death of thyrocytes and follicles.
A hypoechoic node can be of different sizes and numbers. By feeling the gland, the doctor can unequivocally find a malignant node. Its diameter can be more than three centimeters. The probability of finding a node with a diameter less than one centimeter is almost impossible.
A hypoechoic node is not a disease, but the entire result of an ultrasound examination. This formation from 70-90% turns out to be cancerous. It is mainly medullary or follicular cancer, in rare cases anaplastic. The hypoechoic node does not make clear boundaries – this is a symptom of a malignant formation.
DEGREES OF THE NODE
There are degrees of the thyroid gland, which depend on its enlargement. These include:
| Grade of nodular goiter | Diagnostic criteria |
| 0 degree | The gland is not visible and it is not palpable. |
| 1st degree | The gland is not visible, but it is palpable. |
| 2nd degree | The gland is visible when swallowed. |
| Grade 3 | The gland makes the contour of the neck thick. |
| 4 degree | A goiter that disturbs the shape of the neck. |
| 5 degree | The gland becomes large, while squeezing adjacent organs. |
This classification of the degrees of goiter according to OV Nikolaev is used in clinical practice, which was proposed by the World Health Organization in 1994.
WHAT ARE THE DANGERS OF THYROID NODES?
Practice has proven that benign nodes are harmless and do not lead to negative consequences, since they do not grow into malignant tumors, therefore, surgical treatment is prescribed very rarely. The only reason why an operative treatment can be prescribed is the occurrence of complaints from the patient. When no complaints are received from the patient, an endocrinologist is periodically consulted and an ultrasound scan is performed.
In cases with malignant tumors, this is not the case. They can not only worsen the patient’s condition, but also lead to death. Their quick identification and effective expensive treatment will help get rid of a malignant tumor, without causing harm to health. Modern medicine presents whole algorithms, based on which effective treatment is carried out, and doctors can quickly relieve a person of a tumor that has arisen.
SYMPTOMS OF THYROID NODES
Symptoms for this disease are usually absent. To a greater extent, this applies to thyroid cysts and the more common form, colloid nodular proliferative goiter. The only symptoms in this case are the formations themselves (cysts, nodes); as a result, the patient does not bother with anything. If the nodule grows large, the patient may complain of a feeling of tightness in the neck and a cosmetic defect.
With diffuse nodular goiter, the symptoms will be as follows:
- Tachycardia;
- Losing weight, with a lot of food;
- Nervousness.
In general, in all cases, with the exception of follicular cysts and nodular colloid proliferative goiter, the symptoms correspond to those of the disease that contributed to the appearance of the nodules.
DIAGNOSTICS OF THYROID NODES
Diagnostics is carried out in several stages. To establish an initial diagnosis to identify suspicions, it is enough to conduct an initial examination of the patient and probe the thyroid area. Experts distinguish between 5 stages of increase according to the Nikolaev method indicated above. The diagnosis is made on the basis of examination data. To do this, use the following methods:
- MRI (magnetic resonance imaging);
- CT (Computed Tomography);
- Radioisotope scanning;
- TPB (punctuation fine needle biopsy);
- Blood test for the presence of thyroid hormones (T3, T4, TSH.)
As a result of these examinations, the doctor determines whether the thyroid gland is functioning correctly or not.
TREATMENT OF THYROID NODES
Treatment is carried out depending on the reasons for the formation of nodes. Most physicians believe that with nodular colloid proliferative goiter, treatment is not required, in this case dynamic observation is prescribed, and treatment is attributed when the nodes show a tendency to grow for a short time.
Treatment can be medical or surgical, the doctor determines which method to treat the patient. Drug therapy is carried out with drugs that suppress the excessive production of hormones. For this, an effective method is used, which consists in the introduction of preparations of radioactive iodine into the thyroid gland. This procedure helps to reduce and sometimes restore the normal size of the nodes.
With diffuse goiter, hormonal therapy is prescribed, with the help of which the deficiency of the produced hormones is eliminated. The duration of treatment with hormones is on average at least a year, until the return of the prescribed size of the gland. If, as a result of the examination, malignant formations are revealed, they are removed using surgical intervention. Operation on the thyroid gland can be complete or partial, if the formation is caused by an autoimmune process, then the removal of the gland will be complete.
In other cases, the node itself is removed, in the case when there are many nodes, a specific portion of the thyroid gland is removed. Before the operation, it is necessary to undergo an examination and pass the following tests:
- Biopsy;
- Puncture;
- Ultrasound;
- Blood for TSH;
- Blood for HIV, hepatitis, sexually transmitted diseases.
Thanks to modern technology, some of the structures are left – the parathyroid glands, the laryngeal nerve. Removal is performed under general anesthesia, the duration of the operation is about an hour, and the rehabilitation process is 3 weeks.
After the operation, radioactive iodine is also prescribed, due to which the remnants of malignant tumors are destroyed. The patient needs to take hormones for life after surgery .
PREVENTION OF THYROID NODES
An important role in prevention is played by the daily lifestyle, which should include sports (yoga, swimming, etc.). Work in a good team with a pleasant psychological climate. The use of iodized salt, especially in areas with low iodine content in groundwater. Also not unimportant is the diet, which should include the following products:
- Eating seaweed and other algae;
- Fermented milk products should be present in the daily diet;
- Nuts of all kinds, with the exception of peanuts;
- Coarse bread;
- Beekeeping products;
- Green tea;
- Hawthorn, rosehip drinks;
- Vegetables and greens;
- Lemons;
- Dried fruits;
- Seeds.
Do not use:
- Powdered soups;
- Stew;
- Fast food;
- Sauces of all sorts;
- Mustard;
- Ketchup;
- Canned food;
- Marinades;
- Alcohol;
- Chips;
- Margarine;
- Sugar and sweets with its content.
In order not to expose the body to the risk of thyroid nodules, which will lead to long and expensive treatment, it is imperative to take preventive measures. There are risk groups at risk of developing the disease due to iodine deficiency. These include pregnant and lactating women, children and adolescents. They definitely need to take preparations containing iodine (potassium iodide) and be careful about their diet.
It is important to remember that illness can be avoided by taking care of your health, eating right, leading a healthy lifestyle and taking preventive measures.