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Ultrasound image of a thyroid nodule

by John Kok, Endocrinologist & Nuclear Medicine Physician

The term “thyroid nodule” refers to any abnormal growth that forms a lump in the thyroid gland. The thyroid gland is located low in the front of the neck. It is shaped like a butterfly and wraps around the windpipe or trachea. A thyroid nodule can occur in any part of the gland. Some nodules can be felt quite easily, while others can be hidden deep in the thyroid tissue or located very low in the gland where they are difficult to feel.

These days, with modern imaging studies such as ultrasound (US) and computerized tomography (CT), more and more thyroid nodules are being found incidentally. This means the nodules are found during studies that are being done for reasons other than examination of the thyroid gland. It is estimated that 4-8% of adult women and 1-2% of adult men have thyroid nodules that can be felt on physical examination, but closer to 30% of women have nodules detectable by ultrasound. Thyroid nodules may be single or multiple. A thyroid gland that contains multiple nodules is referred to as a multinodular goiter.

Most 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 symptoms of too much thyroid hormone such as weight loss, heat intolerance and heart palpitations (hyperthyroidism). Some patients complain of discomfort or pain at the site of the nodule that can travel to the ear or jaw. If the nodule is very large, it can even cause difficulty swallowing or shortness of breath. In rare instances, a patient may complain of hoarseness or difficulty speaking.

Although the majority of thyroid nodules are benign (not cancerous), about 10% of nodules do contain cancer. Therefore, it is important to evaluate a thyroid nodule to determine whether cancer is present.

An endocrinologist is a specialist doctor who deals with diseases affecting hormone production in the body, including thyroid disorders. Evaluation of thyroid nodules requires a careful history and examination and appropriate investigations such as ultrasound, blood tests, nuclear medicine uptake scan and fine needle aspiration biopsy. An endocrinologist is trained to assess patients with thyroid nodules and determine which investigations and treatments are necessary.

Have you or someone else noticed a lump in front of the  neck?

Dr John Kok is both an endocrinologist and a nuclear medicine physician. His endocrinology practice is at BJC Health, Parramatta. BJC Health provides coordinated, comprehensive, and colocated multidisciplinary care to achieve effective solutions for patients. We call this model of care, Connected Care. Our clinics are located in Parramatta, Chatswood and Brookvale. Contact us.

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