!

Pathology of the thyroid gland

Thyroid gland
diseases

Hyperthyoidism Hypothyroidism Thyroditis Thyroid nodule

•! Thyroid nodules/neoplasms:
o! 90% of the thyroid nodules are benign.
o! To detect the nodule in palpation!it should be 1 cm or more in size
o! Our aim in case of thyroid nodule presence is to determine if it is benign or
malignant:
Benign suggestive Malignant suggestive
•! Movable •! Fixed
•! Unfirm and regular •! Firm and irregular
•! Multiple •! Solitary
•! No history neck irradiation •! Hx of neck irradiation
•! Slowly growing •! Rapidly growing
•! No vocal cords paralysis •! Vocal cords paralysis
•! No cervical adenopathy •! Cervical adenopathy
•! No family history of thyroid •! Increase calcitonin level
malignancies •! Family history of thyroid
•! Hot nodule in scanning malignancies
•! Cold nodule in scanning

•! Diagnoses and treatment:

"! Start with detecting the level of TSH:
o! If low! evaluate for hyperthyroidism and scan
o! If high !evaluate for hypothyroidism and US!if US
confirms nodules ! fine needle aspiration (FNA)
o! If normal! FNA:
"! FNA!malignant!surgery Figure 1: Thyroid Nodule.
"! FNA!benign !observe
"! FNA!suspicious or follicular neoplasm! 123 I scan (if cold ‘no
function!surgery, if hot ‘hyperfunction!observe).

Done by: Rawan Al-Tuwaijri Revised: Jumana AlJohani, Bassam Alghamdi

Format editor: Roaa Amer