Lec:3 endocrine

Lec:3 Dr. Mohammed Alhamdany
Thyroid lump or swelling:
Causes:
A- Diffuse goiter including:
1- Simple goiter.
2- Hashimoto’s thyroiditis.
3- Graves’ disease.
4- Drugs such as Iodine, amiodarone, and lithium.
5- Iodine deficiency (endemic goitre).
6- Transient thyroiditis.
7- Infiltrative such as Amyloidosis, and sarcoidosis.

B- Multinodular goiter.
C- Solitary nodule including:
1- Colloid cyst.
2- Hyperplastic nodule.
3- Follicular adenoma.
4- Thyroid carcinoma.
5- Lymphoma.
6- Metastasis.
Patients with thyroid nodules often worry that they have cancer, but the reality is that only 5–10% of thyroid nodules are malignant. It s important to early identify and treate the malignant one, so the feature that suggest malignancy include:
1- childhood or adolescence, particularly if there is a past history of head and neck irradiation.
2- presenting in the elderly should heighten suspicion of a primary thyroid malignancy.
3- The presence of cervical lymphadenopathy also increases the likelihood of malignancy.
4- Thyroid nodules identified on PET scanning have an approximately 33% chance of being malignant.
5- ‘Cold nodules’ on scintigraphy have a much higher likelihood of malignancy.
6- ultrasound feature of malignancy that include hypervascularity of the nodule, the presence of microcalcification and irregular, infiltrative margins.