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An autonomous thyroid nodule or "hot nodule" is one that has thyroid function independent of the homeostatic control of the HPT axis (hypothalamic–pituitary–thyroid axis). According to a 1993 article, such nodules need to be treated only if they become toxic; surgical excision (thyroidectomy), radioiodine therapy, or both may be used. [32]
A 26-year-old male patient with elevated serum parathyroid hormones and calcium secondary to intra-thyroid parathyroid adenoma. a, b Enhanced axial and coronal CT scan of the neck demonstrate a well-defined hypodense right thyroid nodule (white arrows). c Bone window coronal CT scan shows lytic expansile lesions at the right mandible and left ...
Some experts [13] recommend that nodules > 1 cm (unless the TSH is suppressed) or those with ultrasonographic features of malignancy should be biopsied by fine needle aspiration. Computed tomography is inferior to ultrasound for evaluating thyroid nodules. [14] Ultrasonographic markers of malignancy are: [15] solid hypoechoic appearance
Colloid nodules may be initially identified as an unspecified kind of thyroid nodule. Follow-up examinations typically include an ultrasound if it is unclear whether or not there really is a nodule present. Once the presence of a nodule has been confirmed, the determination of the kind of thyroid nodule is done by fine needle aspiration biopsy. [7]
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2]
The ultrasound may also locate nodules that are too small for a doctor to feel on a physical exam, and can demonstrate whether a nodule is primarily solid, liquid , or a mixture of both. It is an imaging process that can often be done in a doctor's office, is painless, and does not expose the individual to any radiation.
If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10] Ultrasound has a sensitivity of 64-77% and a specificity of 82-90% for the detection of thyroid cancer. [10]
A cold nodule is a thyroid nodule that does not produce thyroid hormone. [1] On a radioactive iodine uptake test a cold nodule takes up less radioactive material than the surrounding thyroid tissue. [1] A cold nodule may be malignant or benign. [1] On scintigraphy cold nodules do not show but are easily shown on ultrasound. [2]