Thyroid nodule

Question 1

Define:

Answer 1

Abnormal growth of thyroid cells that form a lump in the thyroid

Question 2

Aetiology/risk factors:

Answer 2

Most are benign but a small amount can become malignant

Most are adenematous + multiple

Usually non-functioning

Question 3

Epidemiology:

Answer 3

40% of the general population will have one or multiple nodules

More common in women

Most will not be malignant - very small proportion

Question 4

Symptoms:

Answer 4

most are asymp

Usually discovered on self or clinical examination - will be nodular and not smoothly enlarged

If there is a single nodule more likely to be malignant

Will not be big enough to compress the trachea or cause dysphagia

Can cause pain

Question 5

Signs:

Answer 5

Get the patient to drink and swallow water and see if the goitre moves with swallowing

If there is regional lymphadenopathy then it is more likely to be malignant

Question 6

Investigations:

Answer 6

TFT- usually normal but can show hyperthyroidism

Ultrasound - determine character of the nodules

CT/MRI - to determine the extent of the sprad if it is cancer

FNA - cytological analysis

Radionuclide isotope scanning -iodine uptake