The difference between thyroid nodules and nodular goiter

Written by Zhang Jun Jun
Endocrinology
Updated on January 25, 2025
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Thyroid nodules are the clinical manifestations of nodular goiter, and nodular goiter is the cause of thyroid nodules. Nodular goiter generally occurs in iodine-deficient areas, forming these partial or multiple thyroid nodules. Thyroid nodules are the clinical manifestations of nodular goiter; the nodules in the thyroid can be single or multiple and can cause abnormal thyroid function, although thyroid function can also be normal in the early stages. Therefore, when performing an ultrasound, if thyroid nodules are discovered, it is necessary to further assess thyroid function and dynamically track changes in the size of the thyroid nodules to determine whether it is nodular goiter.

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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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"Malignant thyroid nodules" means what?

Thyroid nodules are assessed under ultrasound with a grading system, and if rated at level three or higher, they tend to be more likely to be malignant. The most common malignancy in thyroid nodules is thyroid cancer. Among all types of tumors, thyroid cancer tends to grow slowly and is relatively less malignant. Therefore, if an ultrasound suggests a high likelihood of malignancy in a thyroid nodule, further examinations should be conducted. This can include a fine needle aspiration biopsy, thyroid contrast-enhanced ultrasound, or even direct surgical removal of the malignant nodule for further pathological examination to determine whether it is benign or malignant. Since the degree of malignancy of thyroid nodules is relatively low compared to other malignant tumors, a high grading score on a thyroid nodule should not be overly worrying. It is advisable to proceed with formal medical checks and regular follow-ups, as the five-year survival rate is quite high, exceeding 80%.

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Post-thyroidectomy complications

In clinical practice, for large thyroid nodules that cause compressive symptoms, such as difficulty swallowing, breathlessness, and hoarseness, thyroid nodule excision surgery can be performed. However, this surgery can have sequelae. First, if the excised thyroid tissue is too large, it can easily lead to reduced thyroid function, requiring lifelong supplementation with thyroid hormones for treatment. Secondly, due to the sensitive location of the thyroid gland, which is surrounded by various glands and nerves, injury during surgery can lead to complications such as seizures and hoarseness, which are considered post-surgical sequelae.

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Is thyroid nodule calcification scary?

Thyroid nodule calcification is a common disease of the human thyroid gland. When seeing thyroid nodule calcification, we should not be afraid. Thyroid nodule calcification refers to the dense proliferation of thyroid cells, which, during an ultrasound examination, appears as strong spots, specks, or rings on the thyroid. Thyroid nodule calcification can be divided into coarse calcification and microcalcification. Generally, coarse calcification is benign, and we can continue to observe it. If it is microcalcification, we can conduct a pathological examination. If it is malignant, surgical treatment can be performed; if it is benign, we can continue to observe. Therefore, thyroid nodule calcification is not something to be afraid of.

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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.