Lump in the thyroid gland
introduction
Nodules in the thyroid gland (glandula thyroidea) or enlarged thyroid gland are extremely common. People of different ages get sick, with younger ones suffering much less often. But it affects women much more often than men. As the age progresses, the knots become more and more numerous.
Often times these become knots not noticed. However, if you feel that there are nodular changes in the thyroid gland, it is important to contact the doctor immediately, as these can also be malicious changes.
The thyroid gland is at the front of the neck and hugs the top of the windpipe at the front. The almost butterfly-shaped shape is characteristic, as the thyroid gland consists of 2 larger side parts and a smaller middle part.
The main task of the thyroid gland is to convert the iodide into the hormones triiodothyronine and tetraiodothyronine. It also produces the hormone calcitonin. The hormones are stored in vesicles and released into the blood when needed. Depending on whether the thyroid is in storage or whether it is releasing the hormone, it has a characteristic appearance. If the cells store, then they are flat, if the hormones are just released, the cells are isoprismatic.
Symptoms
The symptoms are highly dependent on the root cause and the location the knot. Especially when nodules stop thyroid function not affect, it can continue to grow unnoticed for a very long time.
With an enlarged thyroid gland (goiter) and multiple lumps, which grow very slowly, however, you may feel pressure in your throat. It can also lead to hoarseness, difficulty swallowing or even difficulty breathing.
Since there are many other structures in the area of the thyroid, such as the windpipe (trachea) or the esophagus (esophagus), compressions and corresponding complaints can also occur here.
If the body does not get enough iodine, this has quite a drastic effect on the organism. The thyroid gland initially enlarges and after a while it can even develop into adenomas (benign tumors). Especially with small ones Children, Infants and unborn children it is very important that you get enough iodine. If the trace element is missing, then it can lead to mental undesirable developments. In adults are initially only fatigue, Difficulty concentrating, Sensitivity to cold and Listlessness noticeable. In some people, there may even be water retention (edema).
causes
The nodes in the thyroid are diseased areas that grow against the remaining cells of the thyroid.
The cause can be a Adenoma be. This is a benign tumor. Although they do not spread and thus do not lead to metastases, they can produce excess hormones that can clog the patient. This can Racing heart, Tremble, Sweat, Weight loss but also be cravings.
The adenomas can be very easily dealt with by a surgery or by destroying with a Radioiodine therapy counteract. Once the adenomas have been removed, the hormonal balance usually levels off again.
Another cause can be Cysts be. The cyst is a cavity in the tissue that can be filled in different ways. In addition to air, tissue fluid and blood can also be found here tallow and pus accumulate. Calcifications and scars can also be a cause.
Unfortunately, one finds it again and again malignant enlargements in the thyroid, i.e. thyroid cancer (goiter maligna).
Malicious causes
In countries where no Iodine deficiency rule, come benign Growths very rarely.
Unfortunately, it is found much more often malicious Tumors. These can be very dangerous. As with everyone Cancer Here, too, it depends on the stage at which the disease was discovered. As mentioned, it exists in the unborn Children or Infantsand young children are at great risk of poor mental development.
diagnosis
A lump can be diagnosed either through a physical examination: Here, however, the lump must have reached a certain size so that it can be felt from the outside.
Or by ultrasound and a thyroid scintigraphy. To see whether the lump is benign or malignant, you should take some tissue (biopsy) and examine it.
Read on below: Thyroid biopsy
In the blood count you can determine hormone imbalances and thus directly diagnose cold or hot lumps. A sufficient medical history should not be missing in any case.
therapy
When treating Thyroid nodules it always depends on the size and the quantity.
It is about one or a few few very small lumps, therapy is usually not necessary. However, it is recommended to use the knot examine regularly allow.
However, the knots are greater and benign, complaints can arise, in some cases they have to be operated on. (Read about this: Thyroid Removal)
It's not just about the size and whether the lump is benign or not - which can be found out through a biopsy, but also that the Hormones a healthy balance take in. If the hormonal balance is not right, you have to Medication take in.
Another therapy at hot knot (this is a knot that is independent of normal hormone production in addition Hormones and can lead to hyperfunction) is the administration of iodine or radio-iodine therapy, which kills the overgrown tissue.
Cold knots However, this cannot be treated as iodine would accumulate here. A Drug therapy performed only when the node is not producing hormones.
surgery
The surgery is another way of removing and treating nodes in the thyroid gland. This option is mostly only used if the node goitre-like is very large, there are extensive growths, or the Malignant node is.
There are two different types of surgery: on the one hand there is a complete removal of the thyroid gland (subtotal thyroidectomy) - usually in malignant growths or when the lump is so large that the organ can no longer be preserved. But there is also the possibility only one remove both flaps (hemithyroidectomy).
Also read: Thyroid Removal.
forecast
As a rule, the prognosis for benign nodules is good. Hyperthyroidism and hyperthyroidism can occur if left untreated. Normally, however, the disease can be kept under control.
cancer
A thyroid carcinoma (goiter maligna) is a malignant growth in the tissue of the thyroid gland. The disease often affects younger people and especially women.
Most tumors originate in the thyroid follicles, the thyrocytes. There are different types of thyroid cancer. Depending on which form you are suffering from, the chances of recovery are better or worse with early detection.
First, a distinction is made between follicular and papillary tumors.
Follicular means that well-defined small tumors or only a single nodule can be found on the thyroid gland. These carcinomas like to spread into the blood and spread the metastases so frequently and early in the lungs and bones. They are also the most common type of thyroid cancer.
In papillary carcinomas, whole foci of small tumors can be found.
A small part of the carcinomas are so-called C-cell carcinomasalso called medullary carcinomas. They have their origin in the C cells, which produce the hormone calcitonin in the thyroid gland, which lowers the calcium level in the blood by helping to increase the amount of calcium excreted and the osteoclasts break down less from the bones. This form of thyroid cancer often metastasizes to the body's lymphatic system very early on.
It must also be mentioned that most tumors are differentiated in the thyroid gland. This means that they still resemble the thyroid epithelium.
Undifferentiated Carcinomas in the thyroid gland usually occur in old age and are extremely aggressive, as their structure no longer resembles the actual tissue of the thyroid gland. The lifetime of these patients is very often very limited. It is assumed that the Iodine deficiency has a not inconsiderable influence on the development of thyroid carcinoma. However, the exact causes have not yet been clarified.
It is also noticeable that people in a radioactive environment suffer from this disease significantly more often. As an example, you can take the Japanese city Hiroshima name in which after the atomic bomb was dropped, many people developed thyroid cancer. It cannot be ruled out that, as with some other cancers, genetic factors play a role here too.
Thyroid carcinoma is treated with a surgeryif possible. The complete thyroid away. Depending on whether the surrounding lymph nodes are affected or not, these are also removed. In addition, patients with a Radioiodine therapy treated if you have an iodine-storing carcinoma.
Metastases, if any, can be removed or treated with radiation or chemotherapy and, ideally, surgery. If the entire thyroid is removed, then the hormones that the organ normally produces must be artificially supplied to the patient.
With advanced carcinoma there is often a complete cure no more possible. However, attempts are made to extend the patient's life as much as possible. In some cases extremely good results are obtained.
The symptoms are not always clear. Often will malicious changes Only discovered very late, usually by the patient himself, since lumps can be felt on the thyroid gland. Some people also feel like they have a lump in their throat. Besides, it can too Shortness of breath and difficulties swallowing as well as hoarseness come.
The doctor makes the diagnosis based on anamnesis and above all an examination with ultrasound, a biopsy and thyroid scintigraphy. It is important to distinguish benign tumors from malignant ones. Differentiated thyroid carcinomas often have a very good prognosis.
Most patients survive the 10-year rate. At undifferentiated carcinoma the prognosis is unfortunately a lot worse. However, it always depends on when the tumor was discovered and at what stage the disease is.
Hashimoto
Hashimoto's chronic immune thyroiditis is an autoimmune disease.
Autoimmune means that the body's own immune system is directed against its own organism. It is a chronic disease of the thyroid gland that causes inflammation in the organ.
In this disease, the thyroid tissue is systematically destroyed by the body's own T lymphocytes. T lymphocytes are responsible for the defense against pathogens. In Hashimoto's thyroiditis there are two different forms, because in chronic Hashimoto's immune thyroiditis there is an enlargement of the thyroid, while in Ord thyroiditis there is a reduction in the size of the thyroid. In both forms, however, you will find very similar or identical symptoms and both ultimately lead to an underactive thyroid. It is a very common autoimmune disease that underlies most hypothyroidism.
As a rule, both sexes are affected equally often. Nevertheless, it has been shown that hormones in particular play a major role, as it is often pregnant women or those who are exposed to increased stress that develop Hashimoto's thyroiditis.
So far, no clear indications have been found as to what ultimately causes the disease. However, it is known that the immune system is directed against the body and that special lymph nodes are formed that attack and destroy the thyroid tissue. Genetic factors are also possible, as there are often several cases of illness within a family. In addition, this disease occurs particularly frequently in connection with severe viral diseases and PCO syndrome.
Research is also being carried out into the extent to which excessive iodine intake can cause the disease. However, all these causes are based on observations that have not yet been adequately proven by studies. The disease can go unnoticed for years and even if the first antibodies show up in the blood, it can take a very long time for the thyroid to malfunction.
Read more on the subject here: Hashimoto's chronic immune thyroiditis
As already mentioned, there is an overactive thyroid at the beginning, but this is only noticed in very rare cases as there are hardly any symptoms. Only when the disease has moved from hyperthyroidism to hypothyroidism do the first symptoms become noticeable in the patient.
However, at first these are very unspecific. People freeze more, and it happens more often cold sweats and increased to edema. In addition, there are some symptoms that are directly related to the neck and the location of the thyroid gland. This can be the feeling of one Dumpling To have in the throat or hoarseness and even the feeling as if someone was pulling your throat off. Besides, the patients are tired and unpowered.
It can lead to indigestion and cardiovascular disease, as well as brittle nails and dull and easily broken hair. In very bad cases, men or women can even become infertile. The symptoms can be natural in theirs intensity vary from patient to patient and rarely does a patient have all of the symptoms listed.
Of the course the disease is usually very mild. In very few cases the disease can become more severe. Only very rarely can one Hashimoto's encephalitis go hand in hand with the disease.
The disease can be diagnosed on the one hand by taking anamnesis and description of the patient's symptoms, on the other hand by ultrasound and a blood count. antibody against the thyroid tissue is usually found late in the blood. An ultrasound image usually provides information earlier about whether the patient is sick or not. In addition, the TSH level when the thyroid becomes underactive. A thyroid scintigraphy and a biopsy are added to the examinations mentioned.
You should urgently refrain from excessive iodine intake. Selenium usually has a beneficial effect on that Antibody defense and is often given in this context. As soon as an underactive thyroid has developed, the patient must be given thyroid hormones as the body cannot produce enough on its own.
