Thyroid disease - thyroid nodules
Description
- *The question is never "is there a nodule" - it is "does this one need a needle"*
- Palpable in ~5% of adults; found on ultrasound in ~50-70%, rising with age
- *Only ~5-10% are malignant*
Differential
- Benign (the great majority)
- Dominant nodule in a multinodular goitre
- Colloid nodule; haemorrhage or degeneration into a nodule (sudden painful enlargement)
- Follicular adenoma
- Simple cyst; Hashimoto pseudonodule; subacute thyroiditis
- Malignant
- Papillary (~85%), follicular (~10%), medullary (~2-3%), anaplastic, poorly differentiated
- Lymphoma (rapidly growing, in a background of Hashimoto)
- Metastasis (renal, breast, lung, melanoma)
- Functioning ("hot") nodule - toxic adenoma; *virtually never malignant*
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