Nodules are simply lumps in the thyroid of which there are two distinct types:
- Hot or warm nodules making up about 15% which have a low risk of cancer and pick up large amounts of iodine to the point of causing hyperthyroidism
- Cold nodules making up 85% of diagnosis with some 10-15% being cancerous in nature withthe remainder being jsut lumps.
Nodules are diagnosed in a number of ways. Thyroid scans are used to determine whether they are hot or cold. Fine Needle Aspiration Biopsy (FNAB) is used to remove cells for analysis, but is inconclusive in up to 30% of cases. Ultrasound Guided FNAB is more reliable. Larger nodules (>3cm) are more likely to be cancerous. A history of neck irradiation implies a higher risk of cancer.
Treatment is very variable. Many patients are simply placed under observation. Thyroxine (T4) can be given to suppress Thyroid Stimulating Hormone (TSH) levels and thereby cause the nodules to shrink. This is called Suppression Therapy. Radioactive Iodine (RAI) is used to destroy hot nodules in some cases and they can also be removed surgically.
