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Nontoxic nodular goiter also known as a Nontoxic Goiter is an enlarged thyroid without hyperthyroidism. [1] It is often present for years before toxic nodular goiter occurs. [1] In the United States it is the most common cause of a large thyroid affecting between 3 and 5% of the population. [2]
The TSHr is expressed on the thyroid follicular cells of the thyroid gland (the cells that produce thyroid hormone), and the result of chronic stimulation is an abnormally high production of T3 and T4. This, in turn, causes the clinical symptoms of hyperthyroidism, and the enlargement of the thyroid gland visible as goiter.
Measurement of thyroid stimulating hormone and anti-thyroid antibodies will help decide if there is a functional thyroid disease such as Hashimoto's thyroiditis present, a known cause of a benign nodular goitre. [4] Fine needle biopsy for cytopathology is also used. [5] [6] [7] Thyroid nodules are extremely common in young adults and children.
A goitre, or goiter, is a swelling in the neck resulting from an enlarged thyroid gland. [ 1 ] [ 2 ] A goitre can be associated with a thyroid that is not functioning properly. Worldwide, over 90% of goitre cases are caused by iodine deficiency . [ 3 ]
The thyroid gland may become firm, large, and lobulated in Hashimoto's thyroiditis, but changes in the thyroid can also be nonpalpable. [13] Enlargement of the thyroid is due to lymphocytic infiltration [14] and fibrosis, rather than tissue hypertrophy.
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).
Thyroid ultrasonography typically shows thyroid gland enlargement and hypoechogenicity, while color Doppler ultrasonography may show low or normal vascular flow. Tissue diagnosis is rare, but fine needle aspiration may be helpful in questionable cases to differentiate unilateral involvement from bleeding into a cyst or tumor.
In case of Riedel's thyroiditis, fibrosis extends beyond the capsule and involves contiguous neck structures, clinically simulating thyroid carcinoma. There is a rapid thyroid enlargement. Compression of trachea, dysphagia are probable outcomes. Marked thyroid follicular cell atrophy confirms hypothyroidism.