Hospital Based Observational Study Summary

According to The National Institute of Diabetes and Digestive and Kidney Diseases, diagnosis of Hashimoto’s thyroiditis begins with a physical exam and medical history. A goiter, nodules, or growths may be found during a physical exam, and symptoms may suggest hypothyroidism. Health care providers will then perform blood tests to confirm the diagnosis. Diagnostic blood tests may include the TSH, which, if above normal lab values, means a patient has hypothyroidism. Blood tests also include T4, which is the amount of thyroid hormone in the blood. In hypothyroidism, the blood lab values are lower than normal. The anti-thyroid antibody tests look for presence of thyroid autoantibodies. Most people with Hashimoto’s disease have these antibodies; however, hypothyroidism isn’t always caused

ATC likely arises from the loss of differentiation of other thyroid carcinomas, including papillary and follicular thyroid carcinomas. Mutations of the proto-oncogenes,

Hypothyroidism is caused by the thyroid’s gland inability to produce thyroid hormone as required by the body. The diagnosis of hypothyroidism requires the laboratory testing of the thyroid stimulating hormone known as TSH. When the TSH is found to be elevated, a clinician should repeat the test along with a free thyroxine (T4) measurement. If the TSH is found to be elevated, while the T4 is normal, the patient is said to suffer from subclinical hypothyroidism. However, if the TSH is elevated and the T4 is low, the diagnosis is primary hypothyroidism (Gaitonde et al., 2012).

The symptoms are initially asymptomatic they begin to appear such as swelling in the neck, swelling in the lymph nodes and pain, hoarseness and difficulty to breath. The causes are exposure to high levels of radiation, inherited genetic syndromes. There are four types of thyroid cancer: papillary, medullary thyroid cancer, anaplastic thyroid cancer, thyroid lymphoma. According to cancercenters Papillary carcinoma is the most common type of thyroid cancer, accounting for approximately 80% of cases. Papillary carcinomas are slow growing, differentiated cancers that develop from follicular cells and can develop in one or both lobes of the thyroid gland. This type of cancer may spread to nearby lymph nodes in the neck, but it is generally treatable with a good prognosis (outlook for survival). Follicular carcinoma is the second most common type of thyroid cancer, and accounts for approximately one out of 10 cases. It is found more frequently in countries with an inadequate dietary intake of iodine. Follicular carcinoma is also a differentiated form of thyroid cancer. In most cases, it is associated with a good prognosis, although it is somewhat more aggressive than papillary cancer. Follicular carcinomas do not usually spread to nearby lymph nodes, but they are more likely than papillary cancers to spread to other organs, like the lungs or the bones. Hurtle cell carcinoma, also known as oxyphil cell carcinoma, is a subtype of follicular carcinoma, and accounts for approximately 3 percent of all thyroid cancers. Medullary thyroid carcinoma develops from C cells in the thyroid gland, and is more aggressive and less differentiated than papillary or follicular cancers. Approximately 4 percent of all thyroid cancers will be of the medullary subtype. These cancers are more likely to spread to lymph nodes and other organs, compared with the more differentiated thyroid cancers. They also frequently

Thyroid nodules, or lumps, are very common. They occur in over half of the world's population, but only 5 per cent of them are cancerous. Nodules are referred to as either 'hot' or 'cold,' depending on the amount of radioactive iodine it concentrates, or takes up, when testing for the type of nodule it is.

Most are common only around 5% coming to be cancerous. Most times when a person has a thyroid nodule they have no symptoms. If the nodule is causing your glands to make too many hormones it can cause what is called hyperthyroidism. Symptoms of this include palpitations, rapid heart rate, anxiety, restlessness and an increased appetite. If your doctor suspects thyroid nodules they will do tests such as an ultrasound or a thyroid scan. A good example of a procedure done by an endocrinologist is an LHRH test. This test is done to see how your pituitary gland is working when it comes to regulating sex hormone production. The night of this procedure you are to not eat or drink anything. When you go in, you will be made comfortable and have a small needle inserted into a vein in your hand or arm. This is just to get a blood sample and is not to stay. Whoever is taking the blood will use a needle such as a ventflon to make drawing the blood sample easy with little to no discomfort. The blood is then checked for hormones LH and LSH then you get an injection to make the levels of those hormones rise. You will have blood drawn twice. Once each after 30

If the gland appears to be enlarged, the physician may order further tests to diagnose or rule out cancer. These tests include: a CT scan or ultrasonography. The ultrasound uses high-frequency sound waves that are emitted and received by a transducer that is passed over the neck region. The sound waves penetrate the body, and by electronic readings, the sound waves are arranged on a computer screen into a picture image of the thyroid gland and any tumors (Thackery 1058). Another test used is the thyroid scan. A patient is given radioactive iodine to drink. After the iodine has been absorbed by the thyroid, the patient must lie on his or her back with the neck region positioned under a scanner. The information received by the scanner is then sent to a computer that displays a 2-dimensional image of the thyroid used to identify areas in the thyroid that do not absorb iodine normally (Surks 165). The most accurate diagnostic tool for thyroid cancer is biopsy. The test is done in a hospital operating room under a general anesthesia. A sedative is usually given by an injection about one hour before the procedure. A small incision is made in the neck, and either side of the thyroid or the entire lump is removed. The sample is sent to a laboratory to be examined. If thyroid cancer is detected, the thyroid is removed (Shin 420).

In figure 1.1, a patient in her 20s is being seen for a sensation of fullness in her neck. The patient had further thyroid testing through ultrasound and other diagnostic tests. Even though she felt normal and her nodules were smaller than the recommended 1.5cm or above, she was told she might have an overactive thyroid by the physician and the patient was given radioactive iodine. The radioactive iodine does the same job as chemotherapy where it wipes out healthy cells along with cancerous cells leading to low or no thyroid function. When the patient came back for a follow up she complained of not feeling the same before she

At this time, it is not clear how much diagnostic radiation is contributing to the increase in thyroid cancer cases. It is possible that the increase in the diagnosis of thyroid cancer can be attributed to a greater rate of detection by use of ultrasonography and fine needle aspiration3. The thyroid tissue itself is among the tissues that are less sensitive to radiation, however, thyroid cancer is still such a concern because the thyroid is so superficial in the body1 (77). “Even doses as small as 50–100 mGy have been associated with an increased risk of thyroid malignancy in children, with a

The pathology I found for this assignment is “Tumor of the Thyroid - Papillary Carcinoma” is the most common type of thyroid cancer, comprising approximately 80% of all primary thyroid malignancies. Benign encapsulated tumor with evidence or follicular epithelial cell differentiation showing growth pattern and cytomorphology different from the surrounding thyroid parenchyma, but lacking features of thyroid papillary carcinoma. Papillary thyroid cancer characteristics: Unencapsulated tumor nodule with ill-defined margins, tumor typically firm and solid, may present as nodal enlargement, commonly metastasizes to neck and mediastinal lymph nodes (40% to 60% in adults and 90% in children), <5% of patients have distant metastases at time of diagnosis, and lung is most common site.

To conclude, Age, gender, and exposure to radiation can affect the risk of thyroid cancer. There are a lot of measures taken to ensure a patient’s safety. Making sure that they are aware of practices taken place is a huge part because when test are performed accurately it takes weight of their shoulders considering their shock of being diagnosed with cancer. Noting information into the patients EMR is essential incase they decide or have to go to another physician that may specialize in this specific cancer. Life becomes very difficult for those who are diagnosed with thyroid cancer. The struggles of having to wake up early morning to take these thyroid pills at the same time everyday becomes a hassle. If you wake up late and forget to take

The preoperative preparation for thyroidectomies for the BMNG patients included the following investigations: neck ultrasound, determination of free T3, free T4, thyroid stimulating hormone and serum calcium concentration, and fine-needle aspiration cytology. Operative Total thyroidectomy is defined as the surgeon’s attempt to perform an extracapsular removal of the entire thyroid gland including pyramidal lobe while preserving the parathyroid glands RLNs, and external branches of the SLNs. The terminal branches of the superior thyroid artery were identified and dissected meticulously as close to the thyroid capsule as possible to avoid damaging the SLN (Fig. 1). The external branch of the SLN travels inferiorly along the lateral surface of the inferior constrictor until it terminates at the cricothyroid muscle (Fig. 2).The delicate technique was performed by seeking, identifying and exposing the RLN itself with all branches, and following its course with care until it entered larynx.

It is very true that a lot of people with thyroid nodules live normal life, only because the vast majority of thyroid nodules are benign, and are in fact not harmful to our bodies. However, you will come across a handful of people that will act frantically if informed that their thyroid ultrasound is showing an image with 3 nodules. Well, there are many ways to interpret the ultrasound result of the image with 3 nodules. Firstly, thyroid nodules are abnormal growth that forms a lump in the thyroid gland. Thyroid nodules may be single or multiple. If the thyroid gland has multiple nodules, as it appears in this scenario, it is referred to as a multinodular goiter. We are already aware that most people have these thyroid nodules. We also know

Nuclear Medicine is a technology that is used predominately by doctors to study the human body using radioactive isotopes across the world. This technology (Nuclear Medicine) is well above the standard technology used such as x-rays and MRI’S, for the fact that it can demonstrate not only the anatomy of the bodies organs but the physical function of those specific organs as well. Thyroid nodules are very common, which exist in half of today’s population. Traditionally, radionuclide was used to preform possible malignancy, that assess the thyroid nodules. Now that we have came across this newfound technology (nuclear medicine) we can now provide the nuclear medicine specialist information involving the the visualization of detection, as well

There can be several internal abnormalities with the thyroid gland and other systems of the body such as the immune system that can show signs of this condition. A few of those internal irregularities are to the actual gland’s size, surface,