Thyroid nodules are common and occur frequently with increasing age. The incidence varies with the respective evaluation method. In patients middle-aged and older patients, shows a palpation at about 5% nodules. Results of sonography and autopsy studies suggest that about 50% of older adults nodules are present. Most nodes are randomly detected by imaging methods in the clarification of other thyroid diseases.
(See illustration of the thyroid function.) Thyroid nodules are common and occur frequently with increasing age. The incidence varies with the respective evaluation method. In patients middle-aged and older patients, shows a palpation at about 5% nodules. Results of sonography and autopsy studies suggest that about 50% of older adults nodules are present. Most nodes are randomly detected by imaging methods in the clarification of other thyroid diseases. Etiology Most nodules are benign. Benign causes are hyperplastic colloid goiter thyroid cysts thyroiditis thyroid adenomas Malignant causes include thyroid malignancies clarification history speak for pain thyroiditis or Zysteneinblutung. An asymptomatic node can be malicious, but is generally benign. Symptoms of hyperthyroidism speak for an autonomous adenoma or thyroiditis, while indicating clinical symptoms of hypothyroidism in Hashimoto’s thyroiditis. Risk factors for thyroid cancer are Earlier thyroid radiation, especially in the infant or childhood age <20 years Male sex Positive family history of thyroid cancer or multiple endocrine neoplasia type 2 A einelner node dysphagia Dysphonia Increasing size (especially rapid growth or growth during a thyroid suppression therapy) Physical examination clinical signs that may indicate a dedifferentiated Schilddrüsenmalignom, a rock-hard consistency or intergrowth with the surrounding tissue, a cervical lymphadenopathy and hoarseness due to Rekurrensparese.Tests are the first evaluation of a thyroid node consists of measurement of thyroid hormones, particularly thyroid-stimulating hormone (TSH) Peroxidaseantikörpern ( TPO) When TSH is suppressed, a radioiodine scanning is performed. Nodules with increased radionuclide uptake (hot) are rarely malignant. If the thyroid function tests show no hyperthyroidism, Hashimoto's thyroiditis, a fine needle aspiration biopsy is performed to distinguish benign from malignant nodes. The early use of a fine needle aspiration biopsy is a more economical approach than the routine use of Schilddrüsenszintigraphien. Ultrasonography is useful in determining the size of the node; fine needle aspiration biopsy is the editors do not routinely for nodules <1 cm (note: the guidelines of the European Thyroid Association (ETA) and the American Clinical Endocrinologists (AACE) recommend a puncture, depending on the sonographic of malignancy possibly even from a diameter of 0.5 cm ( .. Thyroid nodule Guideline Pract Endocr 2010; 16 (Suppl 1)) in the ultrasound or nodules that are completely cystic displayed an ultrasound is rare diagnosis leader in cancer, although given by certain ultrasonic or radiographic findings evidence of cancer. fine spot-like, psammomatöse calcification (papillary thyroid carcinoma) echogenicity, irregular borders, intranoduläre vascularity, height increased larger than the width in cross section, irregular macro (Editor's note: and micro) calcifications or rare dense, homogeneous calcification (medullary res Schilddrüsenarzinom) therapy treatment of the underlying disease, the treatment depends on the underlying disease. A Thyroxinsupression of TSH to shrink smaller benign nodules, is effective in no more than half of the cases and is rarely performed.