file:%2Fvar%2Fmobile%2FContainers%2FData%2FApplication%2F140BF54F-286C-4BFB-A1F3 2.pdf

Goiter

1. GOITRE
Any enlargement of the
thyroid gland.
By
s.Gayathri
GOITRE
DIFFUSE
EUTHYROID HYPOTHYROID
NODULAR
HYPERTHYROID

TYPES:

•Autoimmune: chronic lymphocytic

thyroiditis, hashimoto’s throiditis
•Granulomatous: de quervain’s thyroiditis
•Fibrosing: riedels’ thyroidits
•Infective
•others



THYROID ENLARGEMENT DUE
TO INFLAMMATORY CAUSE:
SOLITARY NODULAR GOITRE DIFFUSE THYROID
ENLARGEMENT
MULTINODULAR GOITRE:

2. CAUSES:

PATHOGENESIS
Cont.,
Approach to solitary nodular
goitre

•Pt is either euthyroid, hypothyroid or hyperthyroid.
•Papable smooth, firm or hard..
•Painless moves freely on swallowing
•Hardness and irregularity- calcification
•Painful nodule, sudden enlargement-haemorrhage into
simple nodule….

CLINICAL FEATURES:

3. •Isolated or solitary( 70%)

•Dominant (30%)

Clinically discrete swelling
COMPLICATION
Risk of malignancy in thyroid
swelling
Investigation
Thy1 Non-diagnostic
Thy1c Non-diagnostic cystic
Thy2 Non-neoplastic
Thy3 Follicular
Thy4 Suspicious of malignancy
Thy5 Malignant
CLASSIFICATION OF FNAC
REPORT:

4. •Indication: Risk of neoplasia (FNAC Thy 3-5)
Symptomatic swelling ( age & sex)
Pressure symptoms. ( hoarseness
of voice)
Lymphadenopathy
Recurrent cyst
Cosmesis

TREATMENT: SOLITARY
NODULAR GOITRE: (
EUTHYROID)

SOLITARY NODULAR GOITRE:
•Extension of lower pole of nodular goitre
•Rare – from ectopic thyroid tissue.
•TYPES: substernal, plunging,intrathoracic
•SYMPTOMS:
•Dyspnoea with cough & stridor
•Dysphagia
•Engorgement of facial, neck & sup chest wall veins. (
SVC obstruction) pemberton sign +




RETROSTERNAL GOITRE:
•INVESTIGATION:
•CHEST XRAY: - superior mediastinal shadow
-Deviation, compression of
trachea
DIAGNOSTIC: CT SCAN
Flow volume loop pulmonary function test
TREATMENT: total thyroidectomy sometimes
by median sternotomy approach

Cont.,

5. THANK
YOU