ENDOCRINOLOGY - THYROID LUMPS Flashcards
How many thyroid lumps are benign and malignant?
95% benign
5% malignant
What is a goitre?
Enlargement of the thyroid gland
What is a multinodular goitre?
A goitre with many nodules
What’s the most common cause of goitre worldwide?
Iodine deficiency but note its not common in the UK
In countries where iodine is added to salt, autoimmune conditions are more common causes
What are risk factors for goitres?
Low iodine consumption
Excessive consumption of iodine
Malignancy
Smoking
FHx
Medications such as amiodarone and lithium
How does goitres present?
Often asymptomatic but may cause pain and may rarely present with features of compression of trachea
What’s a red flag feature for same day referral of goitre?
Strider associated with a thyroid mass
What requires a 2 week rule referral for a goitre?
Child with a thyroid nodule
Unexplained hoarseness or voice changes
Painless thyroid mass enlarging rapidly over a period of a few weeks
Palpable cervical lymphadenopathy with goitre
What are the differential diagnoses for goitre?
Non-toxic goitre
Toxic multinodular goitre
Retrosternal goitre
Hyperplastic nodule
Colloid nodule
Thyroid adenoma
Thyroid cyst
Thyroid carcinoma
Graves’ disease
Hashimoto’s thyroiditis
How do you investigate a goitre?
TFT
Ultrasonography0 first line
Fine-needle aspiration - provides tissue for cytology
CT scans and MRI scans to detect local and mediastinal spread and regional lymph nodes
What are some causes of diffuse goitre?
Physiological
Graves’ disease
Hashimoto’s thyroiditis
Subacute thyroiditis
What are some causes of nodular goitre?
Multinodular goitre
Adenoma
Carcinoma
Who should you worry about a nodule being Malagnant in?
Men
After a thyroidectomy to remove a thyroid follicular malignancy, how can you monitor it?
Check thyroglobulin levels every 3 to 6 months for 2 years after thyroidectomy and every 6 to 12 months after that
