Thyroid - in questions and answers

Most people are worried about "wasting" when problems arise. We will try to dispel the most common doubts of people who have a thyroid problem.

1. What thyroid tests are done?

The basic diagnosis of thyroid diseases includes:

• general laboratory tests (morphology, ESR, peripheral blood smear, determination of cholesterol level)
• hormone tests (TSH level determination)
• Ultrasound imaging ( USG )

In order to make a more specialized assessment, you will additionally:

• imaging examination - radiograph (chest radiograph)
• fine-needle aspiration biopsy (BAC)
• radioisotope test ( scintigraphy )
• determination of the level of antithyroid antibodies and tumor markers

In rare cases, computed tomography or magnetic resonance are recommended.

2. Why is it enough to mark only TSH?

The TSH test is the most sensitive thyroid hormone test. The symbols T3 and T4 are not carried out, as they would be very inaccurate and often error-prone.

3. Does the thyroid nodule mean cancer?

Usually not. Most thyroid nodules are not dangerous. Only a small percentage may turn out to be a cancerous lesion.

Symptoms that may suggest cancerous change include: the presence of single or multiple tumors with an upward trend, long-lasting hoarseness, enlarged lymph nodes, shortness of breath, dysphagia. In addition, it is worth noting that the OB in the case of neoplastic changes is usually a three-digit number. However, only the full diagnostics and assessment of the specialist can confirm the nature of the given disease change.

4. What are warm, cold and hot bumps?

The terms "cold / hot, hot bumps / areas" are used to determine the tissue of the thyroid gland during a scintigraphic examination.

Scintigraphy is a radioisotope study using labeled iodine isotopes. Depending on the degree of uptake of the marker (iodine isotope) by the diseased areas of the thyroid gland are defined as cold (do not accumulate the marker), warm (accumulate a marker more or similar to the rest of the thyroid), hot (very intensely accumulate the marker). The cold area may be caused by the presence of a cyst or inactive hormonal tumor tissue. And the hot area can be caused by adenoma or hormonally active cancer. Usually hot and warm bumps are identified with hyperthyroidism, and cold ones are usually associated with neoplastic changes.

5. Which thyroid diseases are treated with injections of ethanol?

This is one of the methods of treating thyroid nodules, but not all of them. Treatment with percutaneous injections of 70% ethanol to the tumor is an effective method, however, nuisance and painful (therefore, pain relief and anxiety are used). It is not a single treatment; it should be repeated several times depending on the volume of the tumor. Although less frequently used, the method is indicated for people with one or the dominant nodule (when there are more of them, but one of them significantly exceeds the others). It is not suitable for the treatment of thyroid hyperthyroidism.

6. What is an aspiration biopsy? Is it painful?

Fine-needle aspiration biopsy is one of the standard procedures in the diagnosis of thyroid diseases. It consists in puncturing a "disease-altered" place, in order to collect cells and examine them thoroughly under a microscope (cytological analysis). The biopsy is performed under ultrasound guidance. It is usually a painless procedure (although performed without anesthesia), and because a much thinner needle is used than for injections, it should be less painful than venous blood sampling. Any pain that may occur during the injection is of little importance compared to the benefit of the biopsy, and how often it is to resign from surgery (usually it turns out that it is not necessary) or the diagnosis of a cancerous lesion.

7. When is surgical intervention necessary?

• if we are dealing with a malignant tumor or in an alternative to a radioactive iodine therapy
• if the bumps are likely to grow and may contribute to later hyperthyroidism or damage to other organs, e.g. trachea, esophagus
• in a life-threatening condition such as a thyroid disorder (a sudden condition that may develop in the course of unrecognized or ineffective treatment of hyperthyroidism. The patient has disturbed consciousness, high body temperature, may develop heart failure and even coma)
• for aesthetic reasons