Thyroid Nodule

The thyroid is a gland in the neck that takes iodine and produces thyroid hormone. Thyroid hormone helps regulate the body’s metabolism. A thyroid nodule happens when there is an unusual growth in the thyroid gland and can be found on a physical exam or with imaging. The majority of thyroid nodules are benign or non-cancer. Types of nodules include colloid nodule, thyroid cysts, inflammatory nodules, hyper-functioning nodules, lymph nodes, ectopic thymus, and thyroid cancer (less than 5%).

Symptoms

Most nodules do not produce any symptoms and are found incidentally on physical exams or imaging. If the nodules are large, they may produce symptoms of trouble swallowing, voice change, pain in the neck, or enlargement (goiter). Hyper-functioning nodules will have symptoms of hyperthyroidism, which include:

• Weight loss
• Irritability
• Heat sensitivity
• Increased or decreased appetite
• Thinning hair
• Heart palpitations

Diagnosis

Thyroid nodules can be detected on physical exam or found incidentally on imaging of the neck. Some benign thyroid nodules have classic imaging appearances and require either no further examination. Other thyroid nodules do not appear benign on imaging alone and need a fine needle aspiration biopsy to diagnose. An interventional radiologist does this procedure with ultrasound guidance with a pathologist available to prepare and review slides during the procedure. This procedure can be done under varying degrees of sedation from minimal to full general anesthesia, depending on the patient. Most typically, it is performed with just local anesthetic or minimal sedation.

Treatment

Treatment varies depending on the type of nodule and any associated symptoms. Treatment can include surgery in cases of large nodules with symptoms, nodules that may be cancer, and nodules that are proven cancer.