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An autonomous thyroid nodule or "hot nodule" is one that has thyroid function independent of the homeostatic control of the HPT axis (hypothalamic–pituitary–thyroid axis). According to a 1993 article, such nodules need to be treated only if they become toxic ; surgical excision ( thyroidectomy ), radioiodine therapy , or both may be used.
Further evaluation with ultrasound is required for patients less than 35 years old with nodules measuring more than 1 cm in the axial plane. The cutoff size for further evaluation is raised to 1.5 cm for patients more than 35 years old. This recommendation should be applied to the largest thyroid nodule in cases of multiple thyroid nodules.
Low uptake suggests thyroiditis, high uptake suggests Graves' disease, [5] and unevenness in uptake suggests the presence of a nodule. [citation needed] 123 I has a shorter half-life than 131 I (a half day vs. 8.1 days), so use of 123 I exposes the body to less radiation, at the expense of less time to evaluate delayed scan images. [6]
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]
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]
When a nodule is present, thyroid function tests determine whether the nodule is secreting excess thyroid hormones, causing hyperthyroidism. [60] When the thyroid function tests are normal, an ultrasound is often used to investigate the nodule, and provide information such as whether the nodule is fluid-filled or a solid mass, and whether the ...
A cold nodule may be malignant or benign. [1] On scintigraphy cold nodules do not show but are easily shown on ultrasound. [2] Figure 1 illustrates the basic anatomy of the thyroid gland. [3] The case shown in Figure 4 shows a cold nodule quite emphasized representation of the thyroid. The investigation was carried out due to a goiter rating of 3.
Regular monitoring mainly consists of watching for changes in nodule size and symptoms, and repeat ultrasonography or needle aspiration biopsy if the nodule grows. [8] For patients with benign thyroid adenomata, thyroid lobectomy and isthmusectomy is a sufficient surgical treatment.