[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Thyroid nodule [Conditions](https://durgical.com/en/conditions/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Thyroid nodule A thyroid nodule is a lump within the [thyroid gland](https://durgical.com/en/anatomy/thyroid-gland/) in the front of the neck; most are benign, and tests look for the few that are cancer. Updated 2026-10-29 ## Structures involved Tap one to see what it is and open it in 3D. - [Thyroid gland](https://durgical.com/en/anatomy/thyroid-gland/) - [Thyroid cartilage](https://durgical.com/en/anatomy/thyroid-cartilage/) - [Trachea](https://durgical.com/en/anatomy/trachea/) - [Neck lymph nodes](https://durgical.com/en/anatomy/lymph-nodes-of-neck/) - [Recurrent laryngeal nerves](https://durgical.com/en/anatomy/recurrent-laryngeal-nerve/) ## In biochemistry - [Radioisotopes and radioimmunoassay (RIA)](https://durgical.com/en/biochemistry/topics/radioisotopes-and-radioimmunoassay/) - [Iodine](https://durgical.com/en/biochemistry/topics/iodine/) ## In histology - [Thyroid follicles, C cells and parathyroid](https://durgical.com/en/histology/thyroid-follicles-c-cells-and-parathyroid/) ## In embryology - [Thyroid gland: from the foramen cecum to the neck](https://durgical.com/en/embryology/thyroid-gland-from-the-foramen-cecum-to-the-neck/) ## In the clinical exam - [Thyroid examination](https://durgical.com/en/clinical-exam/thyroid-examination/) - [Hyperthyroidism and hypothyroidism: the signs](https://durgical.com/en/clinical-exam/hyperthyroidism-and-hypothyroidism-the-signs/) ## In physiology - [The thyroid axis: reading TSH and free T4](https://durgical.com/en/physiology/the-thyroid-axis-reading-tsh-and-free-t4/) ## Why it happens - [Hyperplasia: physiologic and pathologic](https://durgical.com/en/general-pathology/hyperplasia-physiologic-and-pathologic/) - [Benign vs malignant tumours: the comparison table](https://durgical.com/en/general-pathology/benign-vs-malignant-tumours-the-comparison-table/) - [Frozen section: the intraoperative consultation](https://durgical.com/en/general-pathology/frozen-section-the-intraoperative-consultation/) - [Biopsy: excisional, incisional, core needle, punch and fine-needle aspiration](https://durgical.com/en/general-pathology/biopsy-excisional-incisional-core-needle-punch-and-fine-needle-aspiration/) - [Cytology: the Pap test, fine-needle aspiration and body fluids](https://durgical.com/en/general-pathology/cytology-the-pap-test-fine-needle-aspiration-and-body-fluids/) ## What it is A discrete lesion within the thyroid gland that is distinct from the surrounding tissue on palpation or imaging. Most are benign; the aim is to find the few that are cancer. ## Who gets it Very common; many are found by chance on imaging and their frequency rises with age. They are more common in women and in iodine-deficient areas. ## Causes - Colloid or adenomatous (hyperplastic) nodules - Follicular adenomas - Cysts - Thyroid cancer (a minority) - Thyroiditis ## Risk factors - Female sex and older age - Iodine deficiency - Childhood [head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) radiation (higher cancer risk) - Family history of thyroid cancer or familial syndromes ## Pathophysiology Focal growth of follicular cells, driven by TSH, growth factors or acquired mutations, forms a nodule. Some become autonomous and make thyroid hormone independently of TSH (hot nodules), which are rarely malignant. ## Symptoms and signs - Often none; found on examination or imaging - Painless neck lump that moves with swallowing - Pressure, dysphagia or dyspnoea if large - Symptoms of hyperthyroidism with an autonomous nodule ## Red flags - Hoarseness ([recurrent laryngeal nerve](https://durgical.com/en/anatomy/recurrent-laryngeal-nerve/) invasion) - Rapid growth, hard or fixed nodule - Cervical lymphadenopathy - History of neck irradiation in childhood ## Diagnosis **Clinical** Neck examination for size, consistency, mobility and nodes. **Tests** TSH first; ultrasound-guided fine-needle aspiration of suspicious nodules, reported using the Bethesda system; molecular testing in indeterminate cytology. **Imaging** Neck ultrasound with risk stratification (systems such as TI-RADS); thyroid scintigraphy when TSH is low. ## Differential diagnosis - Thyroid cancer - Multinodular goitre - Thyroiditis - Thyroglossal duct cyst - Cervical lymph node or parathyroid adenoma ## Goal of treatment Exclude malignancy, treat hormonal over-activity or compressive symptoms, and avoid unnecessary surgery. ## Treatment **Follow-up** Ultrasound surveillance for benign or low-risk nodules. **Surgical** Lobectomy or total thyroidectomy for malignant, suspicious or compressive nodules. **Medical** Radioactive iodine or antithyroid drugs for autonomous (toxic) nodules. **Procedure** Aspiration of cysts; image-guided ablation in selected benign nodules. ## Complications - Missed or delayed cancer diagnosis - Compression of [trachea](https://durgical.com/en/anatomy/trachea/) or oesophagus - Hyperthyroidism - Recurrent laryngeal nerve injury or hypoparathyroidism after surgery ## Prognosis Excellent for benign nodules; most remain stable for years. ## Test yourself Think of the answer, then tap the question to see it. ## What is the first blood test in a patient with a thyroid nodule? TSH: a low value suggests an autonomous nodule and leads to scintigraphy. ## Are hot nodules on scintigraphy usually benign or malignant? Usually benign; cold nodules carry the higher risk of cancer. ## Which system reports thyroid fine-needle aspiration cytology? The Bethesda system. ## Which ultrasound features suggest malignancy? Hypoechogenicity, microcalcifications, irregular margins, taller-than-wide shape and extrathyroidal extension. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/thyroid-nodule/) ## Related conditions - [Thyroid cancer (papillary)](https://durgical.com/en/conditions/thyroid-cancer/) - [Goitre](https://durgical.com/en/conditions/goitre/) - [Graves disease (hyperthyroidism)](https://durgical.com/en/conditions/graves-disease/) - [Hypothyroidism](https://durgical.com/en/conditions/hypothyroidism/) - [Cervical lymphadenopathy](https://durgical.com/en/conditions/cervical-lymphadenopathy/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Thyroid Nodule](https://www.ncbi.nlm.nih.gov/books/NBK535422/) (StatPearls (NCBI Bookshelf), 2023). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/thyroid-nodule/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/thyroid-nodule/