Symptoms of thyroid nodules

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 27, 2024
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Thyroid nodules in the early stages often show no clear symptoms, with only small nodules appearing within the body. The size of these nodules can range from several millimeters to several centimeters, and their texture is generally slightly harder compared to the surrounding glandular tissue. When the enlargement is more noticeable, the nodule can move up and down with the thyroid gland during swallowing. In addition to the presence of nodules, when the thyroid nodule is prominent, it can compress the trachea, leading to difficulty breathing and irritative dry cough. If it compresses the recurrent laryngeal nerve, it may cause hoarseness, varying degrees of hoarseness, and even an inability to speak loudly. In patients with malignant nodules, the invasive malignant cells can cause symptoms such as hoarseness, difficulty breathing, dysphagia (difficulty swallowing), diarrhea, palpitations, facial flushing, and decreased blood calcium levels. If these symptoms occur, it is crucial to seek medical attention promptly.

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Written by Luo Juan
Endocrinology
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Can thyroid nodules be treated?

It depends on the situation. For some patients, we can evaluate whether thyroid nodules are accompanied by changes in thyroid function. If there is an overactive thyroid, antithyroid treatment is necessary. If there is underactive thyroid function, appropriate thyroid hormone supplementation is needed, and some patients' nodules can shrink. Additionally, for some thyroid nodules, if there are no accompanying changes in thyroid function, and the nodules are assessed as benign through ultrasound and other evaluations, no special treatment is generally needed. It is recommended to monitor thyroid ultrasound and function every six months to a year. Furthermore, if some thyroid nodules grow rapidly or there is a potential for cancerous changes, or if there are significant compressive symptoms, we can also perform a fine needle aspiration biopsy of the thyroid cells, or surgical treatment. Therefore, whether thyroid nodules can be treated also depends on the situation.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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What is a thyroid nodule?

The thyroid is an endocrine gland located in the neck of the human body. If some abnormal nodules appear in it, they are referred to as thyroid nodules. Based on histological classification, they can be divided into follicular type, papillary type, and mixed type. A common characteristic of these types is that they generally appear as solitary nodules with a relatively complete capsule; the tumor cells differ from the surrounding thyroid tissue; and the cellular structure inside the tumor is relatively consistent. Generally speaking, middle-aged women are the demographic most prone to developing thyroid nodules.

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Written by Li Jin Quan
General Surgery
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How to deal with calcification of thyroid nodules?

Thyroid nodules calcification can be divided into coarse calcification and microcalcification. Coarse calcification is generally benign, and benign conditions do not require special treatment. When a large nodule causes compression symptoms and affects our appearance, surgical removal can be considered. Microcalcification is mostly likely to become malignant, therefore, cytological biopsy of the thyroid should be performed. If it is benign, we can continue to observe it. If it is malignant, we can treat it with surgery, comprehensive therapy, or radiotherapy.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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How to treat thyroid nodules?

Clinically, if a thyroid nodule is confirmed to be a benign tumor, generally speaking, if thyroid function is normal and the nodule is not large, urgent treatment is not necessary, and regular follow-up is sufficient. If the thyroid nodule significantly enlarges, causing compression of the trachea or nerves, surgery should be considered. Furthermore, for ectopic growth of thyroid tissue behind the sternum, surgical removal is also considered necessary. Another scenario that requires special mention is if a thyroid nodule grows rapidly in a short period and ultrasound suggests calcification or bleeding within the cyst, thyroid cancer should be suspected. In this case, it's advisable to have the nodule surgically removed.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid nodule examination checks what

Generally, when thyroid nodules are detected, one should visit the hospital's breast and thyroid surgery department or the endocrinology department. If you find a thyroid nodule, you can consult a doctor and undergo some relevant tests based on your specific situation. Typically, the following tests are conducted: 1. Thyroid ultrasound: This can determine the size, number, location, texture, shape, and edges of the nodules, including whether there is calcification. It also examines the blood supply within the thyroid nodule, the relationship with surrounding tissues, and assesses whether there are lymph nodes in the neck and the nature of these lymph nodes. 2. Blood tests are needed to measure thyroid function, particularly the level of Thyroid Stimulating Hormone (TSH). Higher levels of TSH indicate that the thyroid nodule is more likely to be proliferative, and thus, the risk of thyroid cancer increases. In addition, Thyroglobulin (Tg) can be measured. Another measure is Serum Calcitonin (Ct). If serum calcitonin is > 100 pg/mL, medullary thyroid cancer should be highly considered, as these cancer cells can secrete large amounts of serum calcitonin, causing this marker to significantly increase. Nuclear isotope imaging is also performed. If the nodule is large and TSH levels are low, a thyroid radionuclide scan is conducted to see if the nodule is a hyperfunctioning adenoma. When necessary, a Fine Needle Aspiration Biopsy (FNAB) is also performed. Fine needle aspiration is an invasive test, but it is currently an important and most efficient method to assess the benign or malignant nature of the nodule. It is generally performed under ultrasound guidance.