Goitre

types of goitre in thyroid

1. GOITRE Any enlargement of the thyroid gland. By s.Gayathri

2. TYPES:

3. Autoimmune: chronic lymphocytic thyroiditis , hashimoto’s throiditis Granulomatous : de quervain’s thyroiditis Fibrosing : riedels ’ thyroidits Infective others THYROID ENLARGEMENT DUE TO INFLAMMATORY CAUSE:

4. SOLITARY NODULAR GOITRE DIFFUSE THYROID ENLARGEMENT

5. MULTINODULAR GOITRE:

6. CAUSES:

7. PATHOGENESIS

8. Cont.,

9. Approach to solitary nodular goitre

10. 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:

11. Isolated or solitary( 70%) Dominant (30%) Clinically discrete swelling

12. COMPLICATION

13. Risk of malignancy in thyroid swelling

14. Investigation

15. Thy1 Non-diagnostic Thy1c Non-diagnostic cystic Thy2 Non- neoplastic Thy3 Follicular Thy4 Suspicious of malignancy Thy5 Malignant CLASSIFICATION OF FNAC REPORT:

16. 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)

17. SOLITARY NODULAR GOITRE:

18. 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:

19. 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.,

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