Noticed a large thyroid nodule on your neck? Don’t panic right away. Here are the things you need to know about the causes and symptoms and what to do.
The detection of a small nodule in thyroid gland can generate restlessness and fears. Although in most cases these nodules are benign, you need to go through studies to confirm this. In this article we explain what their causes are and how doctors diagnose them.
We talk about thyroid nodules to refer to cell growths in the thyroid gland in the form of bumps, spots or turgencies. Some of them are detectable by simple palpation, although most of the nodules are small and cannot be felt from the neck.
Thyroid nodules can be solid or cystic. A cystic nodule is one that contains fluid inside and is covered by a capsule that contains it. Solid nodules, on the other hand, are massive throughout their structure.
They can be located in different portions of the thyroid gland, which is made up of two lobes joined by a minor central segment. The gland is in the neck and under normal conditions it is not possible to feel it palpating from the outside.
As the thyroid has among its functions the manufacture of hormones T3 and T4, it can be that a nodule of the gland is functional. This means that it is able to secrete hormones like the rest of normal tissue. In these cases, symptoms linked to this hormonal overproduction appear.
Most thyroid nodules are benign and, among them, doctors detect them only accidentally in a medical consultation for another reason. However, due to the small percentage of nodules that respond to thyroid cancer, the complementary methods necessary for diagnosis should be performed.
The causes behind large thyroid nodules are varied, from alterations in the diet to the proliferation of malignant cells. Let’s look at some of the most important:
Lack of iodine in the diet
When the iodine microcomponent is not present in sufficient quantity in the food we eat, the thyroid gland can form nodules. This classic and historical cause of thyroid disease led several countries to legislate the obligation to artificially add iodine to many foods, including table salt.
These laws appeared in times where it was very frequent that certain regions of the world had a high incidence of goiter; a disease of the thyroid enlargement due to lack of iodine.
This term designates the inflammation of the thyroid gland. When the inflammation is chronic and persistent it can generate nodules. One of the best known varieties is Hashimoto’s thyroiditis, whose symptoms are from hypothyroidism.
Thyroiditis usually responds to autoimmune processes, where the body attacks its own gland with antibodies.
Proliferation of normal thyroid cells
In some circumstances, the usual thyroid cells grow excessively and form a nodule. It is known as thyroid adenoma and is benign.
The problem of adenoma is that it can be functioning. That is, capable of producing hormones and dumping them in the blood. This can lead to the person suffering from hyperthyroidism.
Large thyroid nodules can be cystic, that is, fluid-filled cavities. They are benign and usually nonfunctional, that is, unable to produce hormones.
Thyroid nodules may appear due to lack of iodine, thyroiditis, fluid accumulation or abnormal cell growth. Although they are often benign, it is best to receive a diagnosis with all the necessary tests.
Proliferation of malignant cells
The most dangerous form of thyroid nodules is thyroid cancer. Luckily it is a minimal portion of cases. With an early detection it is approachable with treatments and surgery to prevent its progression.
Symptoms of large thyroid nodules
Thyroid nodules do not usually generate symptoms because they tend to be small and not functional. In many cases, they are discovered by performing a thyroid ultrasound for another reason, or by performing a tomography of the neck region.
When the nodule is detectable from the outside by palpating the neck, then we are in the presence of a sufficiently large formation. These situations can be perceived by a doctor when performing the physical exam or by the same patient.
If there are other symptoms along with the detected nodule such as weight loss, episodes of profuse sweating, changes in heartbeat or difficulty swallowing, then malignancy of the nodule is suspected. Although finally the definitive diagnosis can be benign, the presence of these signs forces to accelerate the accomplishment of the complementary methods.
On the other hand, if we have functional thyroid nodules capable of producing hormones and turning them into the bloodstream, then the symptoms will be those of hyperthyroidism. There will be tachycardia, lack of strength, changes in the nails and hair, diarrhea, irritability and lack of weight gain despite the increase in food intake.
In some cases, when the nodules reach a considerable size, the doctor or the patient himself can detect them with a physical examination.
Before consulting the palpation of a thyroid nodule or the appearance of it in an examination for other causes, the doctor will request a series of studies to characterize the lesion. Among these studies will be:
Dosage of thyroid hormones: through a blood test the levels of T4 and TSH will be measured.
Thyroid ultrasound: if it has not been done previously, it is the first step study to address the thyroid nodule. In the first instance it allows to differentiate between solid and cystic nodules, in addition to measuring the size.
Puncture biopsy: if the doctors suspect of malignancy, they will schedule a biopsy procedure. It consists of introducing a very fine needle to the gland. The doctor extract cells from the nodule to look them under a microscope. Currently, doctors perform the puncture on an outpatient basis, without requiring hospitalization, and usually only with local anesthesia.
Thyroid nodules may appear as a result of several diseases that affect the thyroid gland. Although they are usually benign, an adequate diagnosis is required to rule out that they are not a serious problem. Therefore, before any signal, it is necessary to consult.
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