Patient with a goiter

on 28.8.08 with 0 comments

  • enlargement of the thyroid gland

  • endemic goiter is declared in an area with more than 10% of children with a goiter

  • concerns: compressive symptoms (e.g. dysphagia) , malignancy, hyper-, or hypothyroidism

Causes of goiter

  • endemic

    • iodine deficiency

    • goitrogens

    • genetic factors

  • sporadic

    • iodine deficiency

    • goitrogens

    • genetic actors

    • enzyme deficiency

    • special circumstances: puberty, pregnancy, acromegaly

Causes of goiter

  • TSH-mediated

    • iodine deficiency

    • iodine excess

    • goitrogens

    • enzyme deficiencies, sometimes familial

Histology: follicular cells undergo hyperplasia


  • pressure on and displacement of trachea

  • difficulty breathing

  • stridor

Pemberton’s sign

  • color of face changes after patient raises his arm


  • palpation

  • ultrasound

  • thyroid function tests

Therapy: nontoxic goiter

  • T4 suppression trial if patient is in upper range of normal

  • surgery if obstructive

  • 131I therapy offers limited reduction in size

Thyroid nodules: nontoxic

  • incidence 5-10%

  • identification: palpation, ultrasound

the dark areas on radiograph are areas with increased iodine uptake


  • less than 10 mm in size: follow

  • greater than 10 mm in size: aspirate to r/o malignancy

Goiter and thyroid nodules: important points

  • causes

    • goiter

      • autoimmune, iodine deficiency, thyroiditis

    • nodules

      • clonal expansion of thyroid cells

Category: Pathology Notes



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