Thyroid Nodules

Dr. Nicholas Kaloudis

The thyroid gland is located in the lower front of the neck below the larynx (Adam’s Apple) and above the collarbone.

A thyroid nodule is a lump on the thyroid gland. Thyroid nodules are common and detected in about 6% of women, and 1.5% of men. Sometimes several nodules will develop in the same person. Any time a nodule is discovered in the thyroid gland, the possibility of malignancy must be considered. Fortunately, the majority of thyroid nodules are benign.

Many patients with thyroid nodules have no symptoms whatsoever, and are found by chance to have a lump in the thyroid gland on a routine physical exam or an imaging study of the neck done for unrelated reasons. However, a minority of patients may become aware of a gradually enlarging lump in the front of the neck, and may experience a vague pressure sensation or discomfort when swallowing.

Nodules can be caused by a simple overgrowth of normal thyroid tissue, fluid filled cysts, inflammation (thyroiditis), or a tumor. It is not possible for a physician to determine whether a thyroid nodule is cancerous on the basis of a physical examination. Endocrinologists rely on a thyroid fine needle aspiration in deciding which nodules should be surgically removed.

A thyroid fine needle aspiration(FNA) is a simple procedure that can be performed in the physicians office. The patient does not need to be put to sleep, and can usually return to work or home afterward with no ill effects. A needle is passed into the nodule usually under ultrasound guidance and cells are obtained and fixed on slides and consequently sent to a pathologist for a diagnosis.

Use of fine needle aspiration has drastically reduced the number of patients who have undergone unnecessary operations for benign nodules.

Most patients who appear to have benign nodules require no specific treatment, and can be simply followed with yearly ultrasounds to monitor the progression of the nodule, and for the appearance of any new nodules. No medication is required. If cancer is found, surgical treatment is recommended. The primary goal is to remove all thyroid tissue, along with any abnormal lymph nodes.