Cystic goiter of the thyroid gland
Content:
- Why is cystic goiter dangerous?
- Causes of cystic goiter
- Symptoms of cystic degenerating goiter
- How is goiter with cystic degeneration diagnosed?
- Cystic goiter treatment
- Prevention of cystic goiter
- What are the complications of goiter with cystic degeneration?
Why is cystic goiter dangerous?
Cystic degenerating goiter is a disease of the thyroid gland, which is characterized by the formation of cavities in its tissue filled with viscous contents. This pathology can affect both women and men, but women get sick several times more often.
Depending on the reasons for the development and characteristics of morphological changes, several varieties of cystic goiter are distinguished:
-
True or simple cystic goiter is a benign formation, the walls of which are lined with unchanged epithelium; by the nature of the content, serous and colloidal forms are distinguished (occurs in 3-5% of cases).
- Cystadenoma is a cystic degeneration of the gland, in which benign nodes take on signs of malignancy, most often as a result of impaired blood supply. In the tissue of the organ, cavities are formed, lined with altered epithelium and filled with either blood or serous fluid (30% of the nodes degenerate into cystadenomas).
- Cystic formations with a lateral or central location. Usually they are hereditary pathologies.
- Parathyroid cysts are cavities located on the surface of the glandular tissue.
- Echinococcal cysts - caused by the parasitization of the echinococcus.
- Cystic teratomas.
The last three pathologies of the thyroid gland are inherently different from the rest, but they are often confused with cystic goiter.
Cystic dystrophy of the thyroid gland can be caused by hyperplasia of thyroid follicles, congenital degenerative processes and minor hemorrhages. In some cases, the cysts grow very slowly, and sometimes they grow rapidly over several weeks.
Cystic degeneration of the thyroid gland is characterized by dystrophy of its tissues and an uneven increase in size. Often, cystic cavities replace almost all of the normal glandular tissue. They compress blood vessels, nerve endings and normal tissue, which accelerates degeneration processes. Excessive amounts of hormones are produced in the cystic cavities, which can lead to the development of hyperthyroidism.
Causes of cystic goiter
The main reasons for the development of cystic goiter include:
- Lack of iodine in the body,
- Age-related dystrophic processes in the thyroid tissue,
- Hereditary predisposition
- Hyperplasia of the gland follicles and various dystrophic processes in its tissue,
- The presence of nodes in the thyroid gland,
- Various internal diseases;
- Hemorrhages in the tissue of the gland, which can appear as a result of operations on the neck and throat.
Symptoms of cystic degenerating goiter
In the presence of cystic-degenerative goiter of the thyroid gland, the patient may be disturbed by:
- Feeling of pressure in the neck or attacks of choking;
- Feeling of a "lump" in the throat;
- Difficulty swallowing food (if the gland is significantly enlarged);
- Enlargement and inflammation of the cervical lymph nodes;
- Constant pain in the throat and neck area;
- Hoarseness of the voice;
- Increased heart rate;
- Arrhythmias;
- Trembling hands;
- Nausea and vomiting due to intoxication of the body;
- Fatigue, excessive fatigue, feeling of depression;
- Increased sweating.
On examination and palpation, an enlargement of the gland and the presence of dense formations in its structure can be detected. If the cystic cavities in the gland tissue grow slowly, then the symptoms remain insignificant or absent for a long time.
If any of these signs appear, you should seek help from a doctor. The disease is easier to cure at an early stage than to deal with its late complications.
How is goiter with cystic degeneration diagnosed?
The endocrinologist is engaged in the diagnosis of degenerative cystic goiter. He asks the patient for complaints, specifies the time and order of the onset of symptoms, the presence of thyroid pathologies in the closest relatives. Then the specialist examines the patient, makes palpation and, if necessary, prescribes additional studies.
These may include:
- General urine and blood tests,
- Ultrasound examination of the thyroid gland,
- Immunogram,
- X-ray of the esophagus and chest organs,
- Biopsy of the gland with a fine needle,
- Organ scintigraphy,
- Determination of the content of thyroid hormones in the blood.
The list of studies for each patient is selected individually, taking into account complaints and clinical data.
Cystic goiter treatment
There are two main methods of treatment - conservative and operative. The choice of a particular method depends on the size, shape and location of the cystic cavities, their growth rate, the presence and severity of symptoms of the disease. The main tasks of treatment are the elimination of formations and the restoration of the functions of the thyroid gland.
The doctor can prescribe the following groups of funds:
- Antibiotics,
- Anti-inflammatory,
- Sclerosing substances,
- Iodine preparations,
- Synthetic hormones,
- Other medicines that restore the gland.
Specific funds and their concentration are selected taking into account the dysfunctions of the thyroid gland.
To determine this parameter, studies are carried out such as:
- Clinical analyzes of urine and blood,
- Doppler ultrasound (shows the absence of blood flow in the nodes),
- Ultrasound of the gland (cysts are displayed as hypoechoic formations),
- Cytogram,
- Research of hormonal status.
Cytological analysis of the cystic fluid can rule out processes such as inflammation, cancer, or dysplasia.
Ultrasound examination is an informative and accessible diagnostic method. It allows you to detect cystic formations even of very small sizes. In the case of slow growth, small size (less than 10 mm), no symptoms and provided the thyroid gland is functioning normally, there is no need for treatment. The doctor only recommends that the patient undergo repeated ultrasound twice a year.
If the nodes have a moderate growth rate, then treatment is mandatory. First of all, it is necessary to correct the function of the gland. If not enough hormones are produced, then their synthetic analogues are used. In the case of hyperthyroidism, it is necessary to suppress the function of the thyroid gland with the help of thyreostatics.
If drug therapy does not give a sufficient effect, or the cysts exceed 1 cm in diameter, they resort to surgical intervention. It can be minimally invasive: under ultrasound control, a cyst is punctured, fluid is removed from it, and a sclerosing substance is injected into the cavity. The content is subjected to cytological examination to confirm its good quality.
In severe cases of cystic goiter, it becomes necessary to partially or completely remove the gland.
The indications for this operation are:
- Malignancy of the tumor according to the results of cytological examination,
- Deposition of calcium salts on the walls of the cysts,
- Complications after minimally invasive interventions
- Very fast node growth,
- The presence of severe symptoms.
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Prevention of cystic goiter
In order to prevent cystic degeneration of the gland, the following measures are shown:
- Adequate and regular nutrition, ensuring an adequate supply of vitamins and minerals, especially iodine;
- Taking vitamin and mineral complexes in the winter;
- Regular visits to health resorts, especially for people living in regions with iodine deficiency;
- The use of preventive physiotherapy (for example, magnetic and laser therapy);
- Adequate (but not excessive) sun exposure in the summer;
- Frequent exposure to fresh air;
- Preventive use of mineral waters.
In order not to miss the occurrence of cystic changes in the gland, it is important to undergo an ultrasound examination of this organ every year. For the same purpose, it is recommended to periodically take tests for the level of thyroid hormones. Iodine preparations should only be taken as directed by a doctor to avoid side effects.
Who is at risk?
Most often, cystic goiter is diagnosed in people with the following risk factors:
- Kenetic predisposition;
- Previously not diagnosed nodular formations in the thyroid gland;
- Radiation irradiation of the head and neck area (for example, for the purpose of diagnosing or treating a tumor);
- Presence of adenoma or cancer of the gland.
What are the complications of goiter with cystic degeneration?
A late visit to a doctor can cause complications such as malignant degeneration of cystic cavities, purulent inflammation of the formations, impaired blood supply to the tissue of the gland and neighboring organs, compression of the esophagus or trachea, vocal cords. Therefore, you should be careful about your well-being.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
