Thyroid cysts usually occur without symptoms, as in case with most cysts. Therefore it is difficult to notice appearance of the tumor. One should pay a lot of attention to his health in order to identify the presence of the disease. If you prone to the gland ailment, you should visit doctor so that get thyroid nodules diagnosis in time. Only this way thyroid nodules treatment can be held properly.
Thyroid nodules diagnosis – methods and when they are performed
There are several ways for thyroid nodules diagnosis.
First of all it’s palpation. Then ultrasound is held to confirm the presence of the formation. It also allows to determine its size and structure (goiter, adenoma, thyroid cyst, and so on).
To determine the cyto-morphological structure (benign or malignant) doctors performe fine needle puncture biopsy. During the thyroid nodules diagnosis the cellular composition of the nodule is taken with a needle and syringe and sent to cyto-histological study.
With the help of the puncture method, doctor can also get the contents of the cyst of the thyroid gland. Typically, the content of the cysts (for benign or malignant) is hemorrhagic reddish-brown in color and comprise old blood and cellular elements of the thyroid gland. Congenital thyroid cysts contain clear slightly yellowish liquid. When there is an abscess in the gland, the doctors get pus with puncture.
In order to evaluate abnormalities in the thyroid gland one more thyroid nodules diagnosis should be held, which is blood test. The examination helps to determine the level of thyroid stimulating hormone (TSH, T4, T3).
One more way for thyroid nodules diagnosis is scintigraphy. The procedure means to scan the gland using radioactive isotopes of iodine I-123, I-131 or technetium Tc-99. It determines the nature of the nodules, its hormonal activity, state of the thyroid tissues. Accordingly to the results the nodules and surrounding tissues are divided into:
- “warm” – when the components absorb the same amount of radioiodine as extranodal tissue cancer (operating units);
- “hot” – the nodules accumulate large amount of radioactive iodine than unmodified surrounding thyroid tissue (independently functioning units);
- “cold” – nodes, accumulate radioactive iodine is not accumulated; thyroid nodules diagnosis agent is distributed in an unchanged thyroid tissue. By “cold” nodes thyroid cancer might be meant, however, only 10% of the “cold” nodules are malignant.
CT scan thyroid nodules diagnosis is necessary to be performed when large amounts of the nodules are discovered, or there is suspicion of thyroid nodules to be of malignant nature.
With the symptoms of compression in the neck laryngoscopy is required (examination of the vocal cords and larynx), as well as bronchoscopy (examination of the trachea).
As for radiological techniques as thyroid nodules diagnosis methods, there are several most common. They are pneumography thyroid (to clarify the sprouting of surrounding tissues), angiography (to detect violations of the vasculature), X-ray of the esophagus with barium X-ray of the trachea (to determine the germination or compression of the tumor).
Thyroid nodules treatment
After thyroid nodules diagnosis is performed, and doctor has all the necessary details and information on his hands he can prescribe special procedures and medications to cure the cyst. Though it’s not always necessary.
The small size nodules and cysts of the thyroid gland that are not accompanied with a violation of the patient’s state of health, are treated conservatively. The same pharmaceutical remedies are used that are given for the patients for the thyroid nodules treatment of diffuse nontoxic goiter: thyroid hormone and iodine. The process of hormonal thyroid nodules treatment requires controlled examination of TSH (every 3-4 weeks), and ultrasound of the thyroid gland (every 3 months).
Blood tests to study the presence of antibodies to the tissues of the thyroid gland (in 1 month after therapy started) also must be held regularly. The study allows to avoid autoimmune thyroiditis. They are aggravated during thyroid nodules treatment with iodine medications. When determining in the blood of high titer antibodies iodine is canceled.
Some thyroid nodules treatment includes just dynamic monitoring. Usually this is the case of the nodes and cysts less than 1 cm in diameter.
If the doctor decides monitoring is not sufficient, evacuation puncture is most often held as thyroid nodules treatment. But only in case it is begin. Benign cysts of the thyroid gland without evidence of inflammation can be punctured repeatedly in case of recurrence. But if the thyroid gland cyst quickly accumulates content reaching its original size in a week, it is better to remove it quickly.
Other indications for surgical thyroid nodules treatment are the large sizes, compression of the neck, rapid recurrence of fluid accumulation after a puncture discharge. In most cases with the presence of thyroid cysts doctor performes (hemithyreoidectomia) – removal of thyroid lobe. Thyroid function normally after such an operation is not affected.
The absolute indication for surgical thyroid nodules treatment of nodal education is its malignancy. During the operation, an urgent histopathological identification of malignancy site and its forms are carried out. Upon confirmation of the malignancy in the thyroid gland sometimes its total removal is prescribed (total strumectomy), along with the surrounding adipose tissue or lymph nodes.