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FROM UVA RADIOLOGY & MEDICAL IMAGING

Condition: Thyroid Nodules

A graphic showing a person and a thyroid glad with a thyroid nodule

The thyroid gland is a small, but important organ in the neck that directs hormones which affect our metabolism. Sometimes, growths called nodules can form on the thyroid. Thyroid nodules are usually benign, but sometimes can be cancerous or cause hormonal imbalances.


What Are Thyroid Nodules?

The thyroid is a butterfly-shaped gland in your neck responsible for controlling hormones that regulate metabolism, which in turn affects heart rate, brain function, and other necessary bodily processes. Sometimes, thyroids develop growths called thyroid nodules.

Thyroid nodules are very common: about 50% of people will have thyroid nodules by the time they are 60. These growths usually don’t cause any symptoms and are generally benign. However, in rare cases, thyroid nodules are cancerous and can require medical intervention.

Symptoms and Risk Factors

As stated above, thyroid nodules don’t present with symptoms except in very rare cases. When symptoms are present, though, they can include:

  • Difficulty breathing or swallowing
  • Hoarseness of voice
  • Pain in the neck

There are a variety of factors that play into the risk of developing thyroid nodules. Thyroid nodules are more common in women over the age of 60 and those with a personal or family history of thyroid issues are also more likely to develop thyroid nodules.

The mineral iodine is necessary for the body to produce thyroid hormones. A lack of iodine in the diet can be a contributing factor to thyroid problems and the growth of thyroid nodules. Not getting enough iodine can affect thyroid health dramatically. In the United States, many foods and condiments have naturally occurring iodine (like bread, fish, and milk) or are enriched with iodine (like iodized salt) to make it easier for us to get enough of this essential mineral.

Diagnosing Thyroid Nodules

Diagnosing thyroid nodules is relatively easy. When present, a nodule is usually identifiable as a lump on one side of the neck near the Adam’s apple. If you think you have a thyroid nodule, feel your neck in this area: if you feel a bump, it could be a nodule.

If you think you have a thyroid nodule, you should schedule an appointment with your primary care doctor. Your doctor will perform a physical exam and check for any signs of a thyroid nodule. If they observe a bump that could be a nodule, the next step will be to run some tests to make an official diagnosis. There are 4 general ways your doctor will test for thyroid nodules: blood tests, ultrasound, radiology scans, and Fine Needle Aspiration Biopsy (FNAB).

An infographic with 4 of the main ways doctors check for thyroid nodules

Blood Test

Blood tests for thyroid nodules will usually test for both thyroid hormones. An abnormal level of hormones could signal that the nodule is causing hormonal issues.

Ultrasound

One of the most accurate ways to diagnose a thyroid nodule, ultrasound creates images of the inside of the body using high-frequency sound waves. Your doctor may order an ultrasound of the bump to determine if it is a thyroid nodule.

Radiology Scans

Depending on the nature of the nodule, your doctor may order a CT, MRI, or PET scan done.

 

  • CT Scan–Uses x-rays to create sectional scans of the thyroid and problem area.
  • MRI–Uses magnetic fields and radio waves to create images of the problem area.
  • PET–Radioactive tracers are administered and then a scan is done, making an image of the organs and tissues that absorbed the tracers.

 

Fine Needle Aspiration Biopsy (FNAB)

Using ultrasound to create an image of the growth, an interventional radiologist uses a small needle to extract a cell sample from the nodule. This sample is tested for for cancer and abnormal levels of thyroid hormones, both of which can be warning signs of a thyroid condition.

Treating Thyroid Nodules

Given the fact that most nodules are not cancerous and don’t inhibit normal functions, the most common form of treatment is what is known as “watchful waiting.” During watchful waiting, doctors and patients work together to monitor the nodule with regular checkups. If it grows, starts exhibiting symptoms, or if levels of thyroid hormone go up, doctors will move to treat it quickly.

In the event that a nodule needs treatment, your doctor may you with different options depending on the type of nodule. Common treatment options include medication and surgery, but will vary from patient to patient.

Are you exhibiting signs of thyroid nodules? If you think you are, contact your doctor or the professionals at the UVA Cancer Center to start your screening process as soon as possible.

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