The thyroid is a butterfly-shaped gland in the middle of the neck, located below the larynx and above the clavicles. The gland secretes two hormones, triidodothyronine or T3 and thyroxine or T4.
These hormones play a vital role in the process of metabolism, thereby regulating how the body uses and stores energy. The functioning of this gland is controlled by the pituitary gland, which is positioned just below the brain. The pituitary produces the thyroid stimulating hormone or TSH, which stimulates the thyroid to produce T3 and T4.
One of the problems related to the thyroid is the formation of thyroid nodules. Thyroid nodules are either round or oval in shape and differ from the surrounding normal thyroid tissue. These are at times noticed by the patient itself or could be discovered during a regular examination of the neck. Thyroid nodules are very common and most people are oblivious of their presence. Fortunately, about 95 percent of the thyroid nodules are caused by benign conditions. Nevertheless, it is imperative to rule out the possibility of cancer.
The diagnosis involves tests that determine whether the nodule is benign or malignant, which in turn helps in deciding upon the treatment methodology. There are several diagnostic tests; each providing unique information about the nodule. Tests are based on a patient's medical history, symptoms and physical examination wherein the doctor gives special attention to the size and firmness of the thyroid and any enlarged lymph nodes in the neck.
The most proficient technique for evaluating the type of cells in the thyroid lump is the fine needle aspiration (FNA). During this type of biopsy, local anesthesia is administered to numb the skin over the nodule. However, in some cases anesthesia may not be required. The procedure could cause prolonged bleeding in patients with bleeding disorders. The biopsy involves the insertion of a thin, hollow needle directly into the nodule, in order to extract cells and a few drops of fluid. The sample is withdrawn from 2 to 3 different sites of the nodule. These cells are then observed under a microscope to detect malignancy. FNA biopsies of nodules smaller than one centimeter across are conducted using an ultrasound machine, which assists the doctor in locating the right place to insert the needle.
The results of the biopsy can project the cells in four different groups namely, benign or non cancerous, malignant or cancerous, indeterminant or suspicious and non diagnostic or insufficient. When the test results highlight atypical cells, the evaluation is put in the category of suspicious or indeterminant. These atypical cells do not qualify for being either benign or malignant. Such cells cannot be officially categorized as malignant but they share many common characteristics with thyroid cancer. With time, they may invade surrounding tissues, at which point they are classified as cancer. Therefore, the surgical removal of these nodules is generally recommended. Studies reveal that at the time of surgery, about 10 to 20 percent of suspicious nodules have become invasive and are classified as cancers.In light of these findings, surgery stands as the best option for thyroid identified with atypical cells. This preventive measure can certainly guard the body in future, against any form of invasive cancerous growth.
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