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JAMA Patient Page
December 1, 2004

Thyroid Nodules

JAMA. 2004;292(21):2684. doi:10.1001/jama.292.21.2684

Thyroid nodules are lumps or small growths in the thyroid gland, a hormone-secreting gland located in the neck. About 90 percent of thyroid nodules are benign (noncancerous). In contrast to thyroid nodules, the term goiter is used for enlargement of the entire thyroid gland, which usually occurs because the gland is attempting to produce more thyroid hormone. The December 1, 2004, issue of JAMA includes an article about thyroid nodules and how they should be treated.

RISK FACTORS FOR THYROID NODULES

  • Iodine deficiency—the most common cause of thyroid nodules worldwide but not in the United States—is preventable by use of iodized salt

  • Older age

  • Women are more likely to get thyroid nodules than men

  • Having irradiation therapy on the head or neck as a child (to treat cancer or other diseases)

SYMPTOMS

  • Most of the time, there are no symptoms at all.

  • A nodule may be visible as a lump in the neck that moves with swallowing.

  • If the nodule presses against other structures in the neck, there may be some pressure or pain.

  • Rarely, a large nodule may cause problems with swallowing.

DIAGNOSING THYROID NODULES

  • Thyroid nodules can sometimes be seen as lumps in the neck or can be felt by touching the neck.

  • Blood tests of thyroid function should be done to see if the thyroid is making the normal amount of thyroid hormone although nodules usually do not affect thyroid hormone production.

  • Ultrasound imaging of the thyroid using sound waves can reveal thyroid nodules and their composition.

  • Radioactive iodine scanning can indicate whether a nodule is functioning (incorporating iodine). Almost all thyroid cancers occur in nonfunctioning nodules.

  • Fine-needle aspiration can help determine whether the thyroid nodule is benign or malignant. A very fine needle is guided into the nodule, sometimes using ultrasound imaging, and some of the nodule cells are removed to be evaluated in the laboratory.

TREATMENT

  • Many benign thyroid nodules remain the same size and some shrink on their own.

  • Synthetic thyroid hormone should be taken as a once-a-day pill only if the thyroid hormone levels are low. Administering thyroid hormone does not cause nodules to shrink.

  • Nodules found to be malignant should be surgically removed.

FOR MORE INFORMATION

American Thyroid Association
1-800-THYROID (849-7643)
http://www.thyroid.org

INFORM YOURSELF

To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on hypothyroidism was published in the December 10, 2003, issue.

Source: American Thyroid Association

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

TOPIC: THYROID NODULES

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