THYROID GLAND DISORDERS AND SURGERY
How is a diagnosis made?
The diagnosis of a thyroid function abnormality or a thyroid mass is made by taking a medical history and a physical examination. In addition, blood tests and imaging studies or fine-needle aspiration may be required. As part of the exam, your doctor will examine your neck and ask you to lift up your chin to make your thyroid gland more prominent. You may be asked to swallow during the examination, which helps to feel the thyroid and any mass in it. Tests your doctor may order include:
- Evaluation of the larynx/vocal cords with a mirror or a fibreoptic telescope
- An ultrasound examination of your neck and thyroid
- Blood tests of thyroid function
- A radioactive thyroid scan
- A fine-needle aspiration biopsy
- A chest X-ray
- A CT or MRI scan
Goitres (lumps):
If you experience this condition, your doctor will propose a treatment plan based on the examination and your test results. He may recommend:
An imaging study to determine the size, location, and characteristics of any nodules within the gland. Types of imaging studies include CT or CAT scans, ultrasound, or MRIs.
A fine-needle aspiration biopsy is a safe, relatively painless procedure. With this procedure, a hypodermic needle is passed into the lump, and tissue fluid samples containing cells are taken. This test gives the doctor more information on the nature of the lump in your thyroid gland and may help to differentiate a benign from a malignant or cancerous thyroid mass.
Thyroid surgery may be required when:
The fine needle aspiration is reported as indeterminate, suspicious or suggestive of cancer imaging shows that nodules have worrisome characteristics or that nodules are getting bigger
the trachea (windpipe) or oesophagus are compressed because one or both lobes are very large
Historically, some thyroid nodules, including some that are malignant, have shown a reduction in size with the administration of thyroid hormone. However, this treatment, known as medical suppression therapy, has proven to be an unreliable treatment method.
