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What is Goitre: When thyroid is enlarged in size, is called goiter.
Causes of Goitre
Causes of Bilateral goitre: when both lobe of thyroid is enlarged then it called bilateral i.e. diffuse goitre the various causes for bilateral goitre are as follows: euthyroid simple goitre, Hyperplastic puberty goiter, ,multinodular goiter, colloid goitre or due to thyroiditis, subacute or silent, iodine deficiency goitre, hereditary goitre, Hashimoto thyroiditis, malignancy, tuberculosis , amyloidosis .
One sided goitre (solitary thyroid nodule): It can be due to Follicular adenoma, Colloid (macrofollicular), Simple, Fetal (microfollicular), Embryonal (trabecular), Huirthle cell, Papillary adenoma , Teratoma, Lipoma, Dermoid cyst, Graves disease, Toxic thyroiditis, TSH-secreting pituitary adenoma, Pituitary resistance to thyroid hormone, Goitrogen ingestion, Antithyroid drugs, Antithyroid agents and foods,Iodine deficiency, Familial dyshormonegenesis, Acute and subacute thyroiditis, Idiopathic (simple) thyromegaly, Nodular thyronegaly, Autoimmune (Hashimoto’s) thyroiditis, Thyroid cyst, Thyroid tunors, Adenoms, Hyperfunctioning (hot); hyperthyroid or euthyroid, Nonfunctioning (cold), Carcinoma, Other tumors, Nonthyroidal masses, Lymphadenopathy, Branchaial cleft cyst, Thyroglossal duct cyst. Thyroiditis, Thyroid cyst, Hemiagenesis of thyroid, Infection, Granulomatous disease (e.g., sarcoidosis. Goitre may be associated with normal thyroid hormone values or low or high blood concentration.
Causes of a Solitary Thyroid Nodule: Solitary thyroid nodule goiter can be due to Hyperplastic nodule, tumour, adenoma(follicular neoplasia, hurthle cell neoplasia, cyst, cancer (malignancy papillary or follicular), unilateral hemiagenesis of thyroid lobe., Single solitary thyroid nodule of multinodular goiter, hyperplastic nodule, Thyroid Nodules, Adenoma, Carcinoma, Cyst, Multinodular goiter, Hashimoto thyroditis, thyroglossal duct cyst, Lymphoma, Prior hemithyroidectomy, Thyroid hemiagenesis.
Thyroid Cancers (malignant thyroid neoplasms): Papillary carcinoma, Follicular carcinoma, Medullary thyroid carcinoma, Anaplastic carcinoma, Metastatic carcinoma, Sarcoma, Lymphoma
Nonthyroid lesions: Lymphadenopathy, Parathyroid cyst or adenoma, cystic hygroma, bronchocele, laryngocoele, carotoid aneurysm, metastasis.
Diagnosis: For diagnosis of causes of goiter detail history, examination & certain tests as Thyroid test, thyroid antibodies (TMA/ATG), ESR, Iodine tests and if needed fine needle aspiration cytology & thyroid scan is required. Goitre may be associated with normal thyroid hormone values or low or high blood concentration.
Treatment: Goitre is nearly cured in six months to one year after accurate diagnosis. Sometimes surgery or radioactive iodine therapy is required. At our center we have complete facility for diagnosis & treatment of goiter.
Thyroid Cancer (carcinoma, malignancy, neoplasm), Hurthle cell neoplasm, follicular adenoma can present as solitary thyroid nodule, for proper treatment certain blood test, fine needle aspiration cytology, Thyroid scan & other test are required. Thyroid cancer can be papillary follicular, medullary carcinoma of thyroid, it needs surgery & radioiodine treatment & followed by long term thyroid hormone suppressive therapy.
What is Thyroiditis: Thyroiditis is a condition in which thyroid gland is infiltrated with various inflammatory infiltrates which leads to various dysfunctions of thyroid gland cells. There are different types of thyroiditis such as;
a) Subacute Thyroiditis: In this condition there occurs inflammation i.e. swelling in thyroid gland due to viral infection. Symptoms are swelling in neck, pain in neck, throat pain, fever, along with symptoms & signs suggestive of Thyrotoxicosis. Thyrotoxicosis may sometime, may be followed by hypothyroidism. Tests required for proper diagnosis are thyroid test, ESR, thyroid antibody test & thyroid scan. With appropriate treatment it is cured permanently in two months.
b) Silent Thyroiditis: In silent thyroiditis there occurs leakage of preformed thyroid hormone from thyroid gland in blood due to inflammation (i.e. holes) in thyroid gland. In silent thyroiditis etiology is idiopathic with symptom & signs of thyrotoxicosis but no pain or fever. This may sometimes evolve into hypothyroidism. Tests required for proper diagnosis are thyroid test, ESR, thyroid antibody test & thyroid scan. It can be treated permanently with proper diagnosis & treatment.
c) Hashimoto Thyroiditis: In this condition there occurs swelling of thyroid due to deposition of inflammatory cells in the thyroid as askanzy cells & langerhans cells & some lymphocytes. Symptoms are thyroid enlargement i.e. goiter & symptoms of hypothyroidism & sometimes rarely it may lead to hashimototoxicosis .
d) Post partum Thyroiditis: Post-partum thyroiditis occurs usually with in one year after pregnancy. In this condition there occurs leakage of preformed thyroid hormone from thyroid gland in blood due to inflammation (i.e. holes) in thyroid gland. In silent thyroiditis etiology is idiopathic with symptom & signs of thyrotoxicosis but no pain or fever. This may sometimes evolve into hypothyroidism. Tests required for proper diagnosis are thyroid test, ESR, thyroid antibody test & thyroid scan. It can be treated permanently with proper diagnosis & treatment.
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