Glandular nodule

Introduction Glandular nodules: Nodular goiter, also known as adenoma-like goiter, actually refers to multiple nodules formed by endemic goiter and sporadic goiter. The incidence rate is very high, and it has been reported to reach 4% of the population.

Cause

The pathogenesis and etiology of thyroid nodules are still unclear, and may be caused by multiple factors, such as genetics, radiation, immunity, geographical factors, goiter-related factors, iodine deficiency, chemical stimulation and endocrine changes. Caused by stimulation.

Thyroid-causing substances include certain foods, drugs, water pollution, soil pollution and environmental pollution; thyroid-deficient areas have goiter with nodular goiter; radioactive damage can cause cancer, but decades of experience with 131I treatment Statistics show that the main side effect of radioactive 131I treatment is not carcinogenic, but hypothyroidism, especially long-term dysfunction. In some patients with multinodular goiter, the positive rate of 54.7% was found in TGA and TMA. The positive rate of single nodule was 16.9%. Patients with nodular goiter have congenital metabolic defects that lead to overcompensated hyperthyroidism. The environment lacks the intake of trace elements such as selenium, fluorine, calcium, chlorine and magnesium. In short, the pathogenesis of nodular goiter is more complicated, and it is still not clear and remains to be studied.

an examination

Related inspection

Endocrine function test

Diagnosis: thyroid nodules are mostly benign nodules, which can be single or multiple, some have endocrine function, clinically called nodular hyperthyroidism, and some have no endocrine function, which is general nodular hyperthyroidism, and some have hypofunction. Should be considered for the possibility of thyroid tumors. Simple nodular goiter is generally difficult to diagnose. It has a long history and no symptoms of compression. The general clinical manifestations are normal. The thyroid tissue can be reduced to varying degrees when the thyroid preparation is used. The final diagnosis should rely on pathological examination to determine the nature of thyroid nodules. Only relying on general medical history, physical examination, laboratory tests or radionuclide examinations can not judge and diagnose malignant nodules 100%.

Differential diagnosis

1. Thyroid adenoma: especially with multiple adenomas. Patients with nodular goiter are older and have a longer history. The goiter is lobulated or has multiple nodules of different sizes. The boundary is unclear. The thyroid hormone is treated and the gland is symmetrically reduced. Multiple thyroid adenomas have asymmetrical adenomas that can reach multiple solitary nodules. For example, with simple goiter, the adenoma nodules are more clearly defined, the texture is slightly tougher than the surrounding tissue, thyroid hormone therapy, glandular tissue shrinkage The nodule is more prominent.

2. Nodular goiter with hyperthyroidism and Graves disease. The former endemic goiter is more common in the epidemic area. The age is generally larger, mostly in the 40-year-old or older. It often occurs after many years of nodules, hyperthyroidism. Lighter and less typical. The age of onset of Graves disease is 20 to 40 years old. The thyroid gland is diffuse and swollen, the eyeball is prominent, the fingers are tremor, and the thyroid gland can touch the tremor and hear vascular murmur. Thyroid scans revealed one or several "hot nodules."

3. Other

(1) Thyroid cyst: The thyroid scan is a "cold nodule". B-ultrasound is a cystic nodule. Fine needle aspiration is used to confirm the diagnosis.

(2) thyroid adenoma: mostly single, slow growth, asymptomatic. The thyroid scan is a "warm nodule." If it is a toxic adenoma, it shows "hot nodules." Adenomas can also develop hemorrhage, necrosis and liquefaction as "cold nodules."

(3) Thyroid cancer: There is no symptom other than thyroid nodules in the early stage of thyroid cancer. At this time, it is difficult to distinguish from nodular goiter. Can do acupuncture biopsy, especially the diagnosis of thick needle puncture.

(4) toxic nodular goiter: more common in the elderly, no exophthalmos, abnormal heart more common. Thyroid scan showed multiple nodules with enhanced iodine function, and irregular irregular light developing areas.

(5) Thyroid neoplasms: Follicular thyroid cancer produces thyroid hormones that cause hyperthyroidism. Local sputum and masses, radionuclide scanning, ultrasonography and fine needle aspiration cytology can assist in diagnosis.

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