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Suspicious findings in a nodule are hypoechoic, ill-defined margins, absence of peripheral halo or irregular margin, fine, punctate microcalcifications, presence of solid nodule, high levels of irregular blood flow within the nodule [11] or "taller-than-wide sign" (anterior-posterior diameter is greater than transverse diameter of a nodule).
An incidentally discovered colloid nodule with calcification, shown on CT scan of a 58-year-old female patient. a Non-enhanced axial CT scan of the neck demonstrates a coarse calcification at the left thyroid inferior pole. b Sagittal grey scale ultrasound of the thyroid demonstrates a heterogeneous nodule with a predominant cystic component.
The ultrasound may also locate nodules that are too small for a doctor to feel on a physical exam, and can demonstrate whether a nodule is primarily solid, liquid , or a mixture of both. It is an imaging process that can often be done in a doctor's office, is painless, and does not expose the individual to any radiation.
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2]
Colloid nodules may be initially identified as an unspecified kind of thyroid nodule. Follow-up examinations typically include an ultrasound if it is unclear whether or not there really is a nodule present. Once the presence of a nodule has been confirmed, the determination of the kind of thyroid nodule is done by fine needle aspiration biopsy. [7]
Some experts [13] recommend that nodules > 1 cm (unless the TSH is suppressed) or those with ultrasonographic features of malignancy should be biopsied by fine needle aspiration. Computed tomography is inferior to ultrasound for evaluating thyroid nodules. [14] Ultrasonographic markers of malignancy are: [15] solid hypoechoic appearance
Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism.. It is a common cause of hyperthyroidism [2] [3] in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH).
If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10] Ultrasound has a sensitivity of 64-77% and a specificity of 82-90% for the detection of thyroid cancer. [10]