The thyroid commonly forms lumps and bumps that as doctors we term thyroid nodules. These nodules may be single or multiple (multi).
A large thyroid gland defined as being bigger than the end of your thumb (each lobe of thyroid is usually about the size of your thumb) is termed a goitre.
A goitre may be diffuse (no nodules and is smooth) or nodular. If nodular then the term that you will read is a multinodular goitre.
The vast majority of thyroid nodules are benign but some may be cancer. Therefore tests need to be undertaken to exclude thyroid cancer.
The following tests in order are essential
1. Thyroid blood tests, including thyroid antibodies
2. Thyroid ultrasound
3. Fine Needle biopsy of the nodule
A CT scan, MRI, or nuclear scan may be necessary but are not essential. A nuclear thyroid scan is generally not required and if ordered by your doctor you should ask, "What additional information will be gained by this test that a biopsy and ultrasound will not provide?"
After these tests, a nodule will either be categorised as
A large thyroid gland defined as being bigger than the end of your thumb (each lobe of thyroid is usually about the size of your thumb) is termed a goitre.
A goitre may be diffuse (no nodules and is smooth) or nodular. If nodular then the term that you will read is a multinodular goitre.
The vast majority of thyroid nodules are benign but some may be cancer. Therefore tests need to be undertaken to exclude thyroid cancer.
The following tests in order are essential
1. Thyroid blood tests, including thyroid antibodies
2. Thyroid ultrasound
3. Fine Needle biopsy of the nodule
A CT scan, MRI, or nuclear scan may be necessary but are not essential. A nuclear thyroid scan is generally not required and if ordered by your doctor you should ask, "What additional information will be gained by this test that a biopsy and ultrasound will not provide?"
After these tests, a nodule will either be categorised as
- benign
- suspicious or malignant
- atypical
If benign then generally the right thing to do is to observe. Surgery may be required if the nodule or goitre is very large, retrosternal (behind the chest bone, ie sternum), growing rapidly, or pushing on the trachea (windpipe).
If malignant then surgery will be required and generally the entire thyroid is removed.
Occaionally, the nodule is atypical (not just right). The chances of cancer with this biopsy result is about 10% and generally no other test is helpful. In the vast majority of these cases surgery is required but you should seek a specialist thyroid or endocrine review.
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