Thyroid nodules are basically lumps of cells that form in the thyroid gland. Benign Thyroid nodules are non-cancerous in nature and do not cause much harm. However, they can cause irrittable symptoms such as difficulty breathing or swallowing, voice change, enlargement of the thyroid gland and even pain in the front portion of the neck.
Thyroid cancer develops when cancer cells form in the tissues of the thyroid gland and are mostly rare. Thyroid nodules are generally caused by an overgrowth of normal thyroid tissue. Thyroid Nodules are classified into two categories namely cold and hot nodules based on their capabilities to produce hormones. This guide discusses the importance of understanding types of nodules, their characteristics, symptoms, risks and treatment options and most importantly the role of interventional radiology.
Firstly, what does the Thyroid Gland do?
The thyroid gland is basically a butterfly shaped endocrine gland located in the front portion of the neck. The thyroid gland is responsible for producing the thyroid hormone which prominently controls the body’s metabolism.
To be more specific the thyroid gland controls the speed at which your body the body transforms food into energy. Specific tests such as thyroid stimulating hormone tsh is performed to check if the thyroid hormone is at optimal levels. Too much thyroid hormone means a patient has hyperthyroidism and too little concludes a patient has hypothyroidism.
What is a Cold Nodule Thyroid?
A cold nodule is a thyroid nodule that does not produce thyroid hormones and appears to be darker on a radioactive iodine thyroid scan. Most cold thyroid nodules are not cancer causing, however 15-20% can still be malignant reinforcing the need to evaluate them carefully.
What is a Hot Thyroid Nodule?
A hot thyroid nodule on the other hand is visualized as a hot spot on a thyroid scan. Hot nodules are almost always noncancerous nodules. However, hot thyroid nodules produce excess thyroid hormones which lead to hyperthyroidism. Hot thyroid nodules appear brighter on a thyroid scan and rarely cause thyroid cancer. Nevertheless, Hyperthyroidism may include symptoms such as rapid heartbeat, weight loss and even anxiety.
Cold vs. Hot Nodules
Normal Thyroid Tissue
A normal thyroid tissue which grows in excess causes the occurrence of thyroid nodule. Lack of sufficient amounts of iodine in your diet can also cause your thyroid gland to develop thyroid nodules. So, once the growth of thyroid nodule is noticed, the health care providers usually recommend a thyroid scan to evaluate thyroid nodules to eliminate doubts of malignancy.
Once they confirm normal thyroid function appropriate treatment options are recommended. Most thyroid nodules are not serious and cause very minimal symptoms. But if, abnormalities are observed in diagnostic tests then, further tests such as fine needle aspiration biopsy is suggested to confirm the nature of thyroid nodule.
Cold Nodules
Cold thyroid nodule does not produce thyroid hormones and are a potential reason to cause thyroid cancer. Another reason to be alarmed about cold thyroid nodule is that they produce almost no symptoms, and which make them more dangerous in case they contribute to thyroid cancer.
Hot Nodules
Hot Nodules produce too much thyroid hormone and can be detected only in diagnostic tests such as radioactive iodine test. Hot nodules are mostly benign thyroid nodule. Benign nodules mean they are not cancerous however excess production of thyroid hormones cause hyperthyroidism.
Hyperthyroidism if left untreated for a long period of time can contribute to an enlarged thyroid gland. An enlarged thyroid gland can thereby contribute to multinodular goiter, were multiple nodules in the thyroid gland become overreactive.
Diagnosis of Thyroid Nodules
Diagnosis of Thyroid Nodule can involve multiple steps depending on the type of thyroid nodule and thyroid conditions. Accurate diagnosis can help detect type of thyroid nodules and thereby help a patient start their treatment journey as well. Diagnosis also helps prevent fatal health conditions such as thyroid cancer. Although most thyroid nodules are noncancerous nodules, it cannot be confirmed before a thorough analysis. Here are a few key tests for the diagnosis of thyroid nodule,
Physical examination
In a physical examination, the doctor will take a close look at the thyroid nodules and may request patients to perform simple activities such as swallowing, to check if the thyroid nodules move up and down during this exercise.
Ultrasound Imaging (Thyroid Ultrasonography)
A thyroid ultrasound shows the doctor the size and dimension of the thyroid nodules. The thyroid ultrasound can also detect where the nodule is situated and its characteristics too. It provides accurate diagnosis of thyroid with detailed images and is completely non-invasive in nature. Ultrasound features such as coarse calcifications, tall than wide, increased flow of blood and irregular edges can be helpful to detect thyroid malignancy.
Thyroid Function Tests
Blood tests are prescribed by the healthcare providers to monitor thyroid function and check for abnormalities. TSH, T4, T3, Thyroid Antibodies, Thyroglobulin and Calcitonin are few blood tests that needs checked before drawing to a conclusion.
Fine Needle Biopsy
Fine Needle Aspiration Biopsy is a procedure which involves using a very thin needle and a syringe to pull out cells, tissues and fluids from the thyroid nodules. Then the healthcare provider sends the sample to a cytology lab to get them tested.
Causes of Thyroid Nodules
Family History of Thyroid
Family History of thyroid can be a significant cause for patients to develop thyroid nodules. Genes play a pivotal role in carrying forward multiple traits and characteristics, genetic mutation is also the most common contributor to thyroid cancer as well.
Radiation Exposure
Radiation Exposure has had a significant impact on development of thyroid cancer. Radiation exposure also increases risk of development of benign thyroid nodules and hypothyroidism which refers to an underactive thyroid gland were it does not produce enough thyroid hormone.
Treatment Options for Thyroid Nodules
Observation
Benign nodules may be suggested to be watched over before quick requirement for intervention. This will only be suggested if the thyroid function is also observed at regular intervals. If the thyroid nodule turns out to lean towards thyroid cancer, then thyroid surgery such as thyroidectomy which involves the removal of the thyroid gland is preferred.
Radioactive Iodine Treatment
Radioactive Iodine Treatment also known as RAI is a procedure that is used to treat certain types of thyroid cancer. This radioactive treatment targets cancer cells in specific, to get rid of them permanently. This procedure is completely safe and is preferred as a clever solution to treat specific types of thyroid cancers.
Interventional Radiology
Radiofrequency Ablation (RFA)
Radiofrequency Ablation is a nonsurgical, minimally invasive, Interventional Radiology technique that uses radio waves to create a current that heats a small portion of the nerve tissues. An interventional radiologist uses ultrasound features to precisely detect the area of cancer. They then insert a probe through the skin into the thyroid nodule to send these radio waves which heat up the cancer cells in the nodule, causing them to die.
Thyroidectomy Surgery
Thyroidectomy is an invasive surgical procedure that involves removing a part of the thyroid gland or the entire thyroid gland as a whole. Thyroidectomy can also serve as a solution to treat thyroid nodules in certain cases, depending on its severity. Thyroidectomy is considered a major surgery and is often preferred to treat thyroid cancer as it helps eliminate the risk of any type of reoccurrence.
Conclusion
Understanding the important differences between hot and cold thyroid nodules is crucial for effective management and treatment of thyroid nodules. It also prevents patients from acting too late on severe health conditions such as Thyroid Cancer. Interventional radiology offers innovative options like radiofrequency ablation for managing benign cold nodules, providing alternatives to traditional surgical methods such as Thyroidectomy, while ensuring patient safety and comfort. However, regular follow-ups with healthcare providers remain crucial for optimal thyroid health management.
