Thyroid Nodule Diagnosis.
Is my nodule cancerous?
Most of the time, thyroid nodules do not produce
any symptoms. They are often discovered during routine physical
examinations or when the patient goes to the doctor for something
like the flu, when the doctor will be looking at the throat.
If the nodules are large, they
can push against other parts of the neck, which could produce
some of the following symptoms: difficulty breathing, difficulty
swallowing, hoarseness, changing voice, goiter, or pain in the
If the nodule produces thyroid hormone,
it can result of the same symptoms as hyperthyroidism, which are:
clammy skin, increased appetite, bounding pulse, flushed skin,
nervousness, restlessness, or a loss of weight.
If the nodules are due to Hoshimoto's
disease, they can cause the following symptoms: weight
gain, hair loss, swelling in the face, dry skin, lack of tolerance
to cold temperatures, or fatigue.
When a nodule is discovered, the doctor might
take a variety of courses of action to determine whether or not
the nodule is cancerous. There are three primary ways in which
this is determined.
Fine Needle Biopsy. This is
a simple procedure that can be done at the doctor's office. There
is no special preparation required on behalf of the patient like
fasting, and the patient usually has no problem going home or
back to work immediately. The doctor uses a small amount of anisthetic
and a very small needle to withdraw cells from the nodule. He
might take a few samples from different areas of the nodule. These
cells are sent to a lab to determine whether or not they are cancerous.
There will be one of four possible results from the test. Hopefully
it will be benign (non-cancerous). There is about a 5% chance
that it is malignant (cancerous). It may also be decided that
it is suspicious and requires a thyroid scan. It also may be an
inadequate sample, which is typical if the nodule is a cyst.
Thyroid Scan. Radioactive iodine
is used in a very small amount. Thyroid cancer cells do not absorb
the substance as easily as healthy cells, so the scan allows the
doctor to see if there are cancer cells present. If the nodule
doesn't take up the iodine normally then there may be cancer present.
If it takes the iodine normally, then the chance of cancer is
very remote, and a biopsy may not even be needed.
Thyroid Ultrasound. Sound waves
are used from an ultrasound machine to get a picture of the thyroid.
By using this test, it can be determined if the nodule is solid
or cystic. It also determines the exact size of the nodule. This
test done regularly determines if the nodule is growing or shrinking.
This test can help determine if a fine needle biopsy is needed
and helps in the performance of the biopsy.
After determining the nature of your nodule,
the doctor will be able to decide which type of treatment
or monitoring will be used.