Thyroid Enlargement

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Contents� Embryology and anomalies

� Anatomy

� Physiology and thyroid function test

� Hyperthyroidism and hypothyroidism

� Thyroiditis

� Goitre

� Solitary thyroid nodule

� Neoplasm

� Complications of thyroid surgery

Neck mass

� Thyroid in origin

� Nonthyroid in origin

Nonthyroid in origin� Anatomy

� Skin

� Subcutaneous tissue

� Lymph node

� Muscle

� Blood and lymphatic vessels

� Bone

� Diseases

� Congenital

� Inflammation

� Tumor

� Trauma

� Metabolic

� others

Thyroid in origin

� Diagnosis

� Location

� Move with swallowing

� Shape

Thyroid

� Enlargement

� Function of thyroid

Enlargement

� Diffuse enlargement

� Nodular enlargement

� Solitary nodule

� Multinodular

Thyroid enlargement

� History and physical exam

� Dominant nodule

� Ultrasound

� Thyroid scan

Functional status

� Euthyroid

� Hyperthyroidism

� Hypothyroidism

Functional status

� Clinical features

� Serum T3, T4, TSH

�131 I uptake, T3 suppresstion test

� TSH stimulation test

Diagnosis of thyroid diseases� 1. Nontoxic

� Diffuse goiter (simple goiter)

� Solitary nodule

� Multinodular goiter

� 2. Toxic� Diffuse goiter (GravesL disease)

� Solitary nodule (toxic adenoma)

� Multinodular goiter (Plummer disease)

� 3. Hypothyroid� Diffuse, solitary, multinodular

� Hashimoto thyroiditis

� Iatrogenic

Detail of each disease

Nontoxic diffuse goiter

� Physiologic , endemic, sporadic

� Benign

� Advice , iodine intake, T4 supplement

� Surgery if indicated

Nontoxic solitary nodule

� Important surgical problem

� Differentiate between benign and malignant

� Clinical features, thyroid scan, ultrasound

� FNB

Clinical features

� Family history

� Age < 20 or > 60 years

� Sex

� History of irradiation

� Hoarseness

Clinical features

� Hard and fix mass

� Cervical lymphadenopathy

� Vocal cord paralysis

� Solitary VS multinodular

� Functional status

FNB

� Differentiation between benign and malignant

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