Thyroid nodule physical examination: Difference between revisions
No edit summary |
|||
| Line 58: | Line 58: | ||
Differentiated thyroid carcinoma (particularly papillary carcinoma) involves cervical lymph nodes in 20–50% of patients in most series using standard pathologic techniques, and may be present even when the primary tumor is small and intrathyroidal. | Differentiated thyroid carcinoma (particularly papillary carcinoma) involves cervical lymph nodes in 20–50% of patients in most series using standard pathologic techniques, and may be present even when the primary tumor is small and intrathyroidal. | ||
1455316 | |||
The frequency of micrometastases may approach 90% | The frequency of micrometastases may approach 90% | ||
PMC 5344800 | |||
==References== | ==References== | ||
Revision as of 22:34, 15 August 2017
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
|
Thyroid nodule Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Thyroid nodule physical examination On the Web |
|
American Roentgen Ray Society Images of Thyroid nodule physical examination |
|
Risk calculators and risk factors for Thyroid nodule physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examination should focus on the thyroid gland and the lateral and central neck and should assess for supraclavicular and submandibular adenopathy.
Physical Examination
a rapid pulse rate may suggest hyperthyroidism, and hypertension may occur in the context of multiple endocrine neoplasia, type II (MEN II)
HEENT
- Thyroid nodule
- Solitary or dominant in a multinodular goiter
- Characteristics of the nodule, including:
- Size
- Consistency (e.g., soft, firm, woody, or hard)
- Nodules that are firm or immobile are more likely to harbor cancer than those that are soft or mobile
- Large, firm cervical nodes ipsilateral to the thyroid nodule should suggest the possibility of local metastases from thyroid cancer
- firm to hard, irregular, fixed, nontender nodule is more likely to be a thyroid malignant neoplasm
- A smooth, soft, easily mobile nodule suggests benignancy, as does the presence of tenderness
- some benign nodules can be very hard because of calcifications
- Multinodularity, especially if the nodules all have the same con¬ sistency, is consistent with a be¬ nign multinodular goiter. A nodule or mass that is dominant in size or has a different consistency than other nodules within the gland should be evaluated for malignancy more precisely
- A midline nodule over the hyoid bone that moves up with protrusion of the tongue is likely to be a thyroglossal duct cyst.
- Involvement with adjacent structures
- Cervical lymph nodes, including:
- submental and submandibular nodes
- upper jugular nodes
- midjugular nodes
- lower jugular nodes
- posterior triangle and supraclavicular nodes
- pretracheal, prelaryngeal, and paratracheal nodes
- Deviation of the trachea, which suggests a mass
| follicular adenoma or carcinoma | compressive symptoms such as dyspnea, coughing, choking sensation, dysphagia, inability to lie flat, or hoarseness | hyperthyroidism
1% of follicular adenomas are toxic adenomas, causing symptomatic hyperthyroidism |
|
Differentiated thyroid carcinoma (particularly papillary carcinoma) involves cervical lymph nodes in 20–50% of patients in most series using standard pathologic techniques, and may be present even when the primary tumor is small and intrathyroidal.
1455316
The frequency of micrometastases may approach 90%
PMC 5344800