Nodules are clonal or polyclonal and are due to heterogeneous responses of follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter : no hyperthyroidism present Epidemiology 90% of those [pathologyoutlines.com]

Session: Podium Presentation Program Number: S091 Post Views: 228 « Return to SAGES 2009 abstract archive [sages.org]

Supine dyspnea was the presenting symptom in our patient, and the imaging studies excluded cardiac involvement. [rc.rcjournal.com]

Patients who presented with compressive symptoms and no prior FNA at initial presentation were included in this study. [journals.aace.com]

[…] as mean SD. b Data are presented as No. (%). [zjrms.com]

• Anemia

  […] transport within the thyroid Hereditary : see dyshormonogenetic goiter Plummer syndrome : hyperfunctioning thyroid nodule within a goiter, without ophthalmopathy or dermopathy of Graves disease Plummer-Vinson (Paterson-Kelly) syndrome : iron deficiency anemia [pathologyoutlines.com]

• Transient Hypothyroidism

  During follow-up, one patient (10%) developed persistent hypothyroidism and another (who presented positive antithyroperoxidase levels) developed transient hypothyroidism ( 9 ). [frontiersin.org]

• Pharyngitis

  Pharyngeal structures were visualized which were severely crowded. The epiglottis was large and overhanging. It was difficult to negotiate the FOB below the epiglottis. [aeronline.org]

• Rales

  Her lungs were clear to auscultation, without wheezing, rales, or rhonchi. The cardiac and neuromuscular examinations were normal. [rc.rcjournal.com]

• Exertional Dyspnea

  dyspnea when tracheal diameter is less than 8 mm with stridor or wheezing when the diameter is less than 5 mm Diagnosis Clinical examination Thyroid function tests: TSH, T3, T4 Thyroid peroxidase antibodies Thyroid ultrasound CT or MRI to evaluate extent [pathologyoutlines.com]

• Osteopenia

  Her PHPT was complicated by osteopenia. Cervical ultrasonography and thyroid scintigraphy affirmed the TMNG without finding a parathyroid adenoma. Conclusion: PHPT associated with thyroid nodules is rare. [endocrine-abstracts.org]

• Dysphasia

  Hereditary : see dyshormonogenetic goiter Plummer syndrome : hyperfunctioning thyroid nodule within a goiter, without ophthalmopathy or dermopathy of Graves disease Plummer-Vinson (Paterson-Kelly) syndrome : iron deficiency anemia, glossitis, esophageal dysphasia [pathologyoutlines.com]

If any changes occur, then further workup is indicated. Evidence-based answers from the Family Physicians Inquiries Network [mdedge.com]

[…] and pelvis (23%), however, such lesions in the long bones and skull are less common (6% each [4] Multiple bone site involvement at a given time is also quite frequent (40%), as seen in our patient. [7] Patients with metastatic disease need a complete workup [ijem.in]

• Mediastinal Mass

  mass and is associated with the cervicothoracic sign associated with deviation of the trachea CT not a primary modality for diagnosis, but may be seen incidentally CT may be useful for fully characterizing the extent of substernal (retrosternal) goiter [radiopaedia.org]

• Superior Mediastinal Mass

  Nuclear medicine Tc-99m pertechnetate or radioiodine (I-123) demonstrate an enlarged gland, with heterogeneous uptake thyroid uptake scan determines the activity of the gland Plain radiograph goiter is in the differential for an anterior/superior mediastinal [radiopaedia.org]

• Hypertriglyceridemia

  Her medical history included thalassemia minor and hypertriglyceridemia. Her medications included gemfibrozil 600 mg twice daily and folic acid 1 mg daily. She denied tobacco or alcohol use. [rc.rcjournal.com]

Three of these 8 patients had 1 131 I treatment, 4 patients had 2 treatments, and 1 patient had 3 treatments. These patients did not want subsequent 131 I treatment and were given long-term antithyroid drug treatment. [jamanetwork.com]

If repeat aspirations fail to provide an adequate specimen, close follow-up or surgery (particularly if the nodule is solid) should be considered. 9 Treatment Options for Patients with Multinodular Goiters Several treatment modalities are available for [touchendocrinology.com]

There is no standard treatment and choice of treatment depends on local practice patterns, the activity of the goiter, and the results of FNA of any suspicious nodules. surgery: partial or complete resection radioiodine: occasionally used dose (thyroid [radiopaedia.org]

[…] but may be seen incidentally CT may be useful for fully characterizing the extent of substernal (retrosternal) goiter an enlarged and heterogeneous thyroid gland suggests the diagnosis, which is confirmed by ultrasound or scintigraphy Treatment and prognosis [radiopaedia.org]

The type of cancer (PTC or FTC) was not a significant indicator of prognosis. [ijem.in]

Expectations (prognosis): The prognosis is good with treatment. A persistent goiter may become toxic, causing symptoms of excess thyroid hormones to develop. [uclahealth.org]

Treatment and prognosis ----------------------------------------- Treatment of multinodular goitre may be pursued if the thyroid is hyperfunctioning, or if the goitre is causing local mass effect. [youtube.com]

For most patients with well-differentiated thyroid cancer, the prognosis remains excellent. [endocrinologyadvisor.com]

The etiology of nontoxic MNG is multifactorial, with the important factors including, among others, iodine deficiency (initially manifesting as a simple goiter), genetic predisposition, goitrogens, exposure to ionizing radiation, and history of thyroiditis [empendium.com]

Treatment depends on the underlying etiology and includes, e.g., surgery ( thyroidectomy ) for malignant and autonomous nodules, fine needle aspiration for thyroid cysts, and observation for small, benign nodules. [amboss.com]

[…] follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter : no hyperthyroidism present Epidemiology 90% of those affected are women Develops more frequently during adolescence and pregnancy Etiology [pathologyoutlines.com]

Laboratory Values at Initial Diagnosis Discussion The diagnosis of sarcoidosis is based on the exclusion of other known etiologies of granulomatous pathology. Sarcoidosis can involve many organs without necessarily producing any signs or symptoms. [rc.rcjournal.com]

However, the true etiology of most nontoxic goiters in iodine-sufficient areas is unknown. Symptoms and Signs The patient may have a history of low iodine intake or overingestion of food goitrogens, but these phenomena are rare in North America. [merckmanuals.com]

Wang, C, Crapo, LM The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am 1997 ;26: 189 – 218. Google Scholar Crossref Medline ISI 2. [journals.sagepub.com]

Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

[…] dominant nodule is present Nodules are clonal or polyclonal and are due to heterogeneous responses of follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter : no hyperthyroidism present Epidemiology [pathologyoutlines.com]

This issue has been an important area of research for many years [ 5 ], mostly because the epidemiologic surveillance of endemic goiter requires reliable methods. [ajronline.org]

Vestergaard H, Sigurdsson G: High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area versus high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology [karger.com]

[…] either FNA (based on sonographic criteria) or monitoring (with repeat ultrasounds) if criteria are not met Sonographic criteria for fine-needle aspiration ( FNA ) References: [1] [3] Follicular adenoma Toxic adenoma Toxic multinodular goiter Epidemiology Pathophysiology [amboss.com]

Pathophysiology Toxic nodular goiter (TNG) represents a spectrum of disease ranging from a single hyperfunctioning nodule (toxic adenoma) within a multinodular thyroid to a gland with multiple areas of hyperfunction. [emedicine.medscape.com]

prevent tracheomalacia and extubated her after 36 h after performing leak test. [aeronline.org]

Repas is the former chairman of the professional diabetes advisory committees of the Wyoming and the Wisconsin Diabetes Prevention and Control Programs. [healio.com]

Preventive effect of levothyroxine in patients operated for non-toxic goitre: a randomized trial of one hundred patients with nine years follow-up. [frontiersin.org]

The efficacy of levothyroxine suppressive therapy in preventing recurrence of goiter growth after partial thyroidectomy is less clear. [touchendocrinology.com]

The routine use of iodized table salt now helps prevent this deficiency. Risk factors are being female, being older than 40, having an inadequate dietary intake of iodine, living in an endemic area, and having a family history of goiters. [uclahealth.org]