Normothyroidic single-nodular goiter is a common disease. Now it can be detected and intervented early so that its prognosis is improving significantly. The effectiveness of preventive therapy for nodular goiter by TST releasing inhibition with levothyroxin was examined in 110 patients. The results showed that levothyroxin therapy to inhibit the release of TST is needed for solid lesions. In younger patients with less than 1cm goiter, the result of treatment is more likely to be maximized, the lesions regress completely and the thyroid functions are normalized. For more than 45-year patients with more than 2-cm goiter, the result of treatment is poor. Use levothyroxin with cautions in over 60-year patients who have cardiovascular diseases and multiple nodular goiter.
Goiter, Nodular ; Prevention & control

Goiter, Nodular ; Humans ; Thyroid Neoplasms

Goiter, Nodular ; diagnosis ; Humans ; Thoracic Wall ; pathology

Foreign Bodies ; diagnosis ; Goiter ; Goiter, Nodular ; diagnosis ; Humans ; Neck

There is a lot of difficulty in the diagnosis of follicular lesions of the thyroid by fine needle aspiration cytology(FNAC). The main purpose of this report is offering more guidance regarding the cytologic appearance to distinguish follicular neoplasm from nodular goiter and laying stress on the presence of mixed group. The histologic and cytologic findings of 23 follicular neoplasms and 13 nodular (adenomatous) goiters were reviewed. Histologic specimens were classified into the microfollicular(MIF), mixed(MIX), and nodular goiter(NG) groups. The comparison of histologic patterns with histologic diagnosis revealed that all the lesions with predominantly microfollicular, trabecular, or solid pattern were follicular carcinoma and all the lesions with predominantly macrofollicular pattern were nodular goiter. The distinguishing cytologic features for the MIF group were irregular cell arrangement in cell groups(100%, p=0.00001), absence of atrophic follicular cells(100%, p=0.0007), abundant microfollicles(100%, p=0.002), pleomorphic nuclei(100%, p=0.002), not predominant syncytial smear pattern(100%, p=0.002), heterochromatin(100%, p=0.032), absence of macrofollicles(100%, p=0.038), scant colloid(100%, p=0.04), clear background(83%, p=0.00006), and uniform sized follicles(83%, p=0.014). And regular cell arrangement(honeycomb appearance) in cell groups(85%, p=0.0000), atrophic change of follicular cells(69%, p=0.0002), syncytial smear pattern(54%, p=0.006), monomorphic nuclei(85%, p=0.008), and hemorrhagic background(100%, p=0.027) were characteristic features of the NG group. Seventeen out of 36 cases(47%) were the MIX group composed of combined cytologic features of the MIF and NG groups. Therefore the frequent presence of the MIX group is considered to be main cause of the difficultyin the diagnosis of follicular lesions by FNAC. The mixed morphologic feature may support the hypothesis of a biologic "continuum" between nodular goiter and follicular neoplasm of thyroid gland.
Biopsy, Fine-Needle* ; Diagnosis ; Goiter ; Goiter, Nodular* ; Thyroid Gland*

Goiter, Nodular ; complications ; diagnosis ; Humans ; Lymphatic Diseases ; complications ; diagnosis ; Thyroidectomy

Recessive mutations of the SLC26A4 (PDS) gene on chromosome 7q31 can cause sensorineural deafness with goiter (Pendred syndrome, OMIM 274600) or NSRD with goiter (at the DFNB4 locus, OMIM 600791). H723R (2168A>G) is the most commonly reported SLC26A4 mutations in Korean and Japanese and known as founder mutation. We recently experienced one patient with enlarged vestibular aqueduct syndrome. The genetic study showed H723R homozygous in the proband and H723R heterozygous mutation in his family members. The identification of a disease-causing mutation can be used to establish a genotypic diagnosis and provide important information to both families and their physicians.
Asian Continental Ancestry Group ; Databases, Genetic ; Deafness ; Goiter ; Goiter, Nodular ; Hearing Loss, Sensorineural ; Humans ; Vestibular Aqueduct

Bronchogenic Cyst ; diagnosis ; Diagnostic Errors ; Goiter ; Goiter, Nodular ; diagnosis ; Humans ; Neck

A unilateral thyroid agenesis that is found coexisting with a huge nodular goiter is very rare. We present a 43-year old woman with a recent history of a respiratory difficulty and a painless mass in the right side of her lower neck. A CT scan of her neck showed a 9x5 cm sized solid mass in the right infra-thyroid and thoracic area and left thyroid agenesis. The patient underwent surgery. The mass was identified as a structure separated from the right lobe of the thyroid, compressing the trachea. The histology revealed it to be a nodular goiter. The patient had an uneventful postoperative recovery and subsequently indicated euthyroid with normal normal calcium levels.
Calcium ; Female ; Goiter ; Goiter, Nodular ; Humans ; Neck ; Thyroid Dysgenesis ; Thyroid Gland ; Trachea

BACKGROUND AND OBJECTIVES: The aim of this retrospective study was to evaluate the significance of sonographically detected thyroid calcifications in the diagnosis of thyroid cancer. SUBJECTS AND METHOD: Two hundred ninety-one patients with thyroid disease, including 75 with thyroid cancer and 54 with calcified thyroid nodule, were reviewed during the period of January 2001 to May 2003. Each patient underwent preoperative high resolution sonography to evaluate the thyroid gland for the presence of calcifications. RESULTS: The highest incidence of calcification was found in thyroid cancer (36%), followed by multinodular goiter (20%), follicular adenoma (13%), and single nodular goiter (3%). The incidence of cancer was significantly higher in calcified nodules (50%) than in noncalcified nodules in the entire group (20%) (p<0.001), with a relative risk of 3.9. In the group of solitary thyroid nodules, the incidence of cancer in the calcified nodules (56%) was higher than that in the nodules without calcification (21%) (p=0.002). In the group of multiple thyroid nodules, the incidence of cancer in the calcified nodules (47%) was higher than that in the nodules without calcification (19%) (p=0.001). The relative risk in presence of calcification was 4.6 in the solitary nodules and 3.7 in the multiple nodules. Compared with multiple noncalcified thyroid nodules, the solitary calcified nodules demonstrated a relative risk of 5.2. In patients younger and older than 40 years, the relative risk in the presence of calcification was about the same, around 4. CONCLUSION: The detection of thyroid calcifications by sonography is diagnostically valuable. The presence of calcifications should raise the suspicion of malignancy.
Adenoma ; Diagnosis ; Goiter ; Goiter, Nodular ; Humans ; Incidence ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography