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Thyroid Nodules (cont.)

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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 cause difficulty swallowing or shortness of breath by compressing the esophagus (tube connecting the mouth to the stomach) or trachea (windpipe). In rare instances, a patient may complain of hoarseness or difficulty speaking because of compression of the larynx (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 regarding the body's needs), the nodule is referred to as autonomous.
    • Such a nodule may cause signs and symptoms of too much thyroid hormone, or hyperthyroidism.
    • Less often, patients with a thyroid nodule may have too little thyroid hormone, or hypothyroidism
    • . Hypothyroidism is most common in the context of Hashimoto's thyroiditis, a condition characterized by painless autoimmune destruction of the thyroid.
  • The most common types of single thyroid nodules are noncancerous colloid nodules or follicular adenomas.
  • Another type of benign nodule that may be seen is called a Hurthle cell adenoma. Up to 24% of Hurthle cell nodules are cancerous.
  • Few 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 at the time of diagnosis.
  • In addition to thyroid cancer of the cell types mentioned previously, thyroid nodules may contain lymphoma (a cancer of the cells of the immune system). Cancer from other sites, such as breast and kidney, can also spread (metastasize) to the thyroid.

The cause of most thyroid nodules is unknown. In certain cases, insufficient iodine in the diet can cause the thyroid to develop nodules, but this is no longer common in the U.S. Certain genes may contribute to development of thyroid nodules.

Medically Reviewed by a Doctor on 8/11/2016


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