What is a Thyroid Nodule?
Thyroid nodules are round or ellipse-shaped lumps that develop within the thyroid. They are quite common in society; Nodules can be seen on ultrasound examination in almost half of individuals over the age of 50. Thyroid nodules are 4 times more common in women than in men.
How many types of nodules are there?
Thyroid nodules are divided into three types, hot, warm and cold, according to the degree of hormone secretion. They leave. Hot nodules secrete more hormone than normal thyroid tissue, warm nodules secrete as much hormone as normal thyroid tissue, and cold nodules secrete less hormone than normal thyroid tissue. Warm and cold nodules do not cause a change in the hormone level in the blood, but hot nodules cause a clinical picture called hyperthyroidism. The degree of hormone secretion of a thyroid nodule can be understood by thyroid scintigraphy. In scintigraphy, hot nodules appear very dark, warm nodules appear normal, and cold nodules appear light colored. Scintigraphy is usually performed in patients with high thyroid hormones in the blood to understand which nodule in the thyroid produces excessive hormones.
How are they diagnosed?
Thyroid nodules More than 90% are benign, but between 5-10% can be malignant (cancer). Thyroid nodules are usually detected by thyroid ultrasonography. Thyroid ultrasonography is the method that best displays the thyroid gland and nodules. Thyroid ultrasound not only shows nodules, but also gives insight into the possibility of them being cancerous. In general, nodules with irregular edges, black color, high blood flow and containing areas of calcification are more likely to be cancerous. The more these features a nodule has in thyroid ultrasound, the higher the probability of that nodule being cancerous.
The simplest and most reliable way to understand whether a nodule detected in the thyroid gland is benign or cancerous is fine needle aspiration biopsy (FNAB)is to be performed. In this painless procedure, which is performed by interventional radiologists under local anesthesia, under ultrasound guidance, and takes only a few minutes, a very thin needle is entered into the nodule, vacuum is applied to the syringe, and cells are removed from the tissue. Later These cells spread on the glass and are examined by pathology.
FNAB examination may yield three types of results: The nodule may be cancerous, benign, or the result may be suspicious. If the nodule is cancerous in the FNAB examination, part or all of the thyroid is removed surgically. Then, radioactive iodine treatment may be applied to destroy the remaining cells.
What should be done if there are suspicious results in the fine needle biopsy?
FNAB
The third possible result is that the nodule is suspicious for cancer. This is an unsettling situation for both the patient and the doctor. For this reason, in patients whose FNAB results are suspicious, part or all of the thyroid is usually removed by surgery due to fear of cancer. However, when the pathology results of such patients are examined, it can be understood that almost 90% of the patients do not actually have cancer, and therefore most of the patients undergo unnecessary surgery. However, in such patients, a second needle biopsy performed using the trukat method can make a definitive diagnosis to a large extent and unnecessary surgeries can be prevented. The reason for this is that larger pieces of tissue can be taken with trucut biopsy compared to FNAB and the pathology can make a more definitive diagnosis. In recent studies, it has been shown that approximately 80-90% of patients with suspicious results can be diagnosed with trucut biopsy. For this reason, trucut biopsy should be performed first in such patients, and if definitive results cannot be obtained in trucut biopsy, then surgical operation should be considered.Read: 0
