Thyroid Nodules (cont.)
Ruchi Mathur, MD, FRCP(C)
Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Jay W. Marks, MD
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
In this Article
- Introduction to thyroid nodules
- What is the prevalence of thyroid nodules and cancer?
- What are the symptoms of thyroid nodules?
- What are the types of thyroid nodules?
- How are thyroid nodules diagnosed?
- What is the treatment of thyroid nodules?
- Thyroid Nodules At A Glance
- Find a local Endocrinologist in your town
What are the symptoms of thyroid nodules?
The vast majority of thyroid nodules do not cause symptoms. However, if the cells in the nodules are functioning and producing thyroid hormone on their own, the nodule may produce signs and symptoms of too much thyroid hormone (hyperthyroidism). A small number of patients complain of pain at the site of the nodule that can travel to the ear or jaw. If the nodule is very large, it can compress the esophagus or trachea and cause difficulty swallowing or shortness of breath. In rare instances, a patient may complain of hoarseness or difficulty speaking because of compression of the larynx (or voice box).
What are the types of thyroid nodules?
Thyroid nodules may be single or multiple. A thyroid gland that contains multiple nodules is referred to as a multinodular goiter. If the nodule is filled with fluid or blood, it is called a thyroid cyst. If the nodule produces thyroid hormone in an uncontrolled manner without regard to the body's needs, the nodule is referred to as autonomous. This type of nodule may cause signs and symptoms of too much thyroid hormone or hyperthyroidism, as mentioned above. Occasionally, patients with a thyroid nodule may have too little thyroid hormone or hypothyroidism. This is most often seen when the hypothyroidism is due to Hashimoto's thyroiditis, an inflammatory, autoimmune disease of the thyroid gland.
The most common types of noncancerous, single thyroid nodules are colloid nodules or follicular adenomas. Another type of benign nodule that may be seen is called a Hurthle cell adenoma. Only a minority of nodules are cancerous. Cancerous nodules are classified by the types of malignant thyroid cells they contain. These cell types include papillary, follicular, medullary, or poorly differentiated (anaplastic) cells. The prognosis for the patient depends largely on the cell type and how far the cancer has spread by the time it is discovered.
In addition to thyroid cancer of the cell types mentioned, thyroid nodules may contain lymphoma, a cancer of the immune system. Cancer from other sites, such as breast and kidney, also can spread (metastasize) to the thyroid gland.
The cause of most thyroid nodules is not known. In certain cases, a lack of iodine in the diet can cause the thyroid gland to develop nodules. There also are certain genes that may be involved in the development of nodules in some individuals.
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