Thyroid nodules are solid or fluid-filled lumps that form within your thyroid. The thyroid gland is located in front of the neck just above the neckline and is shaped like a butterfly, with two lobes on either side of the neck connected by a narrow band of tissue.
The great majority of thyroid nodules aren’t serious and don’t cause symptoms. However, thyroid cancer does account for a small percentage of thyroid nodules. A few thyroid nodules are cancerous (malignant) but it’s difficult to tell which nodules are malignant by symptoms alone. Although size isn’t a predictor of whether a nodule is malignant or not, cancerous thyroid tumors are more likely to be large fixed masses that grow quickly.
You often won’t know you have a thyroid nodule until your doctor discovers it during a routine medical exam. Some thyroid nodules, however, may become large enough to press on your windpipe, making it uncomfortable or difficult to swallow.
Several conditions can cause one or more nodules to develop in your thyroid gland: Iodine deficiency; Overgrowth of normal thyroid tissue; Thyroid cyst; Chronic inflammation of the thyroid (thyroiditis); Multinodular goiter; Thyroid cancer.
Although the chances that a nodule is malignant are small, you’re at higher risk if you have a family history of thyroid or other endocrine cancers, are younger than 30 or older than 60, are a man, or have a history of radiation exposure, particularly to the head and neck. A nodule that is large and hard or causes pain or discomfort is more worrisome in terms of malignancy.
Tests and Diagnosis:
Testing for thyroid nodules usually involves an Ultrasound of the thyroid and diagnosis is performed with Ultrasound-Guided Fine Needle Aspiration biopsy.
What is Ultrasound of the Thyroid?
Ultrasound uses high-frequency sound waves rather than radiation to produce images. It provides the best information about the shape and structure of thyroid nodules and may be used to distinguish cysts from solid nodules, to determine if multiple nodules are present and as a guide in performing a fine-needle aspiration biopsy. Although Ultrasound is very good at detecting nodules in the thyroid gland, it is not always possible to tell from an ultrasound whether a nodule is benign (non-cancerous) or cancerous. This is why certain thyroid nodules must be evaluated with Ultrasound guided Fine Needle Aspiration (FNA).
What is Ultrasound-Guided Fine Needle Aspiration (FNA) Biopsy of the Thyroid?
FNA biopsy is a minimally-invasive procedure that helps to distinguish between benign and malignant thyroid nodules. During a fine needle aspiration biopsy of the thyroid, a small sample of tissue is removed under ultrasound guidance by our specially trained board-certified radiologist, Dr. Sunita Mann, who has advanced experience in needle aspirations and ultrasound of the thyroid gland. Several specimens are taken for a complete analysis.
At Shore Imaging, Dr. Sunita Mann performs these biopsies on an out-patient basis and the specimen is immediately handed off to a cytopathology technologist who comes for each of these procedures from the Pathology lab. The technologist looks at the specimen under a microscope and lets Dr. Mann know right away if the specimens are adequate for diagnosis. This means no uncertainty about whether there is enough tissue in the biopsy specimen. These samples are then sent to the Pathologist who examines them under a microscope to determine a diagnosis.
What are the benefits and risks?
Benefits
The results of needle biopsy of the thyroid are close to 95% accurate for adequate biopsies. Needle biopsy is a reliable method of obtaining tissue samples that can help diagnose whether a nodule is benign (non-cancerous) or malignant. A needle biopsy is less invasive than open and closed surgical biopsies, both of which involve a larger incision in the skin and often require general anesthesia. Generally, the procedure is not painful and the results are as accurate as when a tissue sample is removed surgically. Recovery time is brief and patients can soon resume their usual activities.
Risks
Bleeding at the site of biopsy is usually minimal because of the small size of the needle used. Infection is very uncommon.
Injury to structures adjacent to the thyroid is avoided by the use of the ultrasound for guidance.
Treating cancerous nodules:
If a thyroid nodule is cancerous, surgery is usually required. Generally, most or all of your thyroid gland is removed, after which you’ll need to take thyroid hormone replacement therapy for the rest of your life. Most thyroid cancers are found early, though, and have a good prognosis.
Find out more:
If your doctor has determined that you should have a thyroid ultrasound or Ultrasound-guided FNA biopsy of a thyroid nodule, contact Shore Imaging at 732-364-9565 today.
