Thyroid gland diseases (goiter) (Part two)

Thyroid gland diseases

• Water-filled cysts;
• cloudy content cysts (colloid) that are usually numerous;
• solid benign nodules (hyperplasia), single or more than one;
• benign tumors (adenoma) normofunctioning or hyperfunctioning (Plummer's disease);
• differentiated malignant tumors, with low malignancy grade (papillary or follicular adenocarcinoma);
• differentiated malignant tumors, with medium malignancy grade (medullary carcinoma);
• undifferentiated malignant tumors, with high malignancy grade (carcinomas);
• Thyroiditis or otherwise widespread infection throughout the gland which in most cases is autoimmune;
• Diffuse hyperfunctioning goiter (Basedow's disease);
• Intrathoracic goiter located within the mediastinum behind the sternum ("chest breeder")
• Hypothyroidism and endemic goiter;

When it occurs in endemic areas, endemic goiter with hypothyroidism is caused by a lack of iodine, which as we said is essential for the synthesis of T3 and T4 hormones. The gland suffers from this deficiency and tries to overcome this situation by activating TSH. Thus, hypertrophy (enlargement of it) occurs;

Simple goiter: is just the increase in the volume of the gland and is not accompanied by either hypothyroidism or hyperthyroidism.

We can distinguish two forms of goiter:

1. Endemic form; stimulation of ACTH causes the gland to increase its volume.
2. Sporadic form; during adolescence and pregnancy, a defect in the synthesis of iodothyronine occurs, and for this reason, the volume of the gland increases.

Clinical signs of thyroid gland diseases

Some of the main signs are:

• the enlargement of the gland varies, from a small nodule to a large bulge in the front part of the neck.
• A feeling of pressure in the neck area.
• Difficulty in breathing, cough, wheezing (due to tracheal compression) which is rare.
• Difficulty swallowing (due to esophageal compression), also rare.
• Hoarseness.
• Pressure on the neck veins.
• Dizziness when the arm is raised above the head.
• Rapid heartbeats.
• Excessive sweating.
• Hand tremors.
• Nervousness.
• Unmotivated fatigue, constipation, dry skin.
• Weight gain.
• Menstrual disorders.

DIAGNOSIS

The diagnosis of goiter is usually made by clinical examination at the doctor's. When the presence of goiter is verified or suspected, thyroid function tests are recommended to determine whether the gland is in an active or hyperactive phase. Further tests will vary depending on the evaluation of the gland function tests. More commonly, a Thyroid Ultrasound or examination with radioactive iodine scintigraphy is done, or others depending on the suspected pathology (benign, malignant, infectious, etc)