Should thyroid nodules be punctured?

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 18, 2024
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Thyroid fine needle aspiration is a reliable and highly valuable diagnostic method we use to distinguish between benign and malignant thyroid nodules. Generally, thyroid nodules with a diameter >1 cm are considered for fine needle aspiration. Fine needle aspiration is not routinely considered in the following situations: (1) The nodule has already been evaluated with a nuclear scan indicating a hyperfunctioning adenoma due to hyperthyroidism; (2) The nodule is purely cystic; (3) The nodule is highly suspected to be highly malignant. In cases where the nodules grow rapidly and significantly enlarge, causing compression of the surrounding trachea and symptoms such as breathing difficulties and hoarseness, these thyroid nodules requiring surgery do not necessitate further fine needle aspiration treatment.

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Where to do acupuncture for thyroid nodules?

Thyroid nodules do not require acupuncture treatment. The vast majority of thyroid nodules are benign, with only a small portion, about 5%, being malignant. We generally determine the treatment approach based on whether the nodule is benign or malignant. For benign nodules, we typically follow up with observation, while malignant nodules require surgical treatment and oral medication, or Iodine-131 radiotherapy. The primary evaluation for distinguishing between benign and malignant nodules relies on the results of color Doppler ultrasound and the pathology results from thyroid fine-needle aspiration.

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Symptoms of thyroid nodules

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 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.

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Can thyroid nodules heal themselves?

Thyroid nodules cannot heal on their own, but with appropriate treatment, good recovery can be achieved. Thyroid nodules are a common clinical disease, with many causes. Nodules can be either solitary or multiple, and the incidence of multiple nodules is relatively higher. Regardless of the cause, thyroid nodules are more common in middle-aged women, with the most common symptoms including thyroid enlargement, neck discomfort, and localized thyroid pain. When people are diagnosed with thyroid nodules, there is no need to be overly worried. If the color ultrasound and thyroid function tests show no abnormalities, it is possible to observe the condition dynamically, with a follow-up check about once a year. If there is a high suspicion of malignant nodules, it is advisable to opt for early surgical removal, which typically yields very satisfactory results.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Is thyroid nodule ablation a good treatment?

Thyroid nodule ablation has its advantages over traditional surgery, but it also has its shortcomings. The advantages include minimal trauma, less bleeding, and less pain for the patient. Ablation involves inserting an ablation needle through the skin of the patient's neck, directly into the tumor to perform the ablation with the goal of eliminating the nodule. Since it does not require cutting, it reduces damage to surrounding tissues and bleeding, allowing the patient to resume activities earlier and reduce suffering. However, the drawback is that ablation is effective for smaller benign thyroid masses, but for complex or malignant thyroid nodules, the treatment effectiveness is poor, and its use is not advocated.