Non-palpable Thyroid Nodules in a Borderline Iodine-sufficient Area: Detection by Ultrasonography and Follow-up

Overview

Journal J Endocrinol Invest

Publisher Springer

Specialty Endocrinology

Date 2002 Jan 5

PMID 11765046

Citations 22

Authors

T Rago

L Chiovato

F Aghini-Lombardi

L Grasso

A Pinchera

P Vitti

Affiliations

Soon will be listed here.

Abstract

Thyroid ultrasonography was performed in 482 subjects, free of known thyroid disease and living in a borderline iodine-sufficient urban area, to assess the prevalence of non-palpable thyroid nodules and evaluation their evolute during a 3-yr follow-up. The mean (+/-SD) thyroid volume in the whole study group was 10.9+/-3.7 ml and was higher in males (12.9+/-3.6 ml) than in females (9.2+/-2.9 ml) (p<0.0001). Thyroid volume was correlated with body surface, height and weight, while no correlation was present with lean and fat body mass. Goiter was found in 5/256 females and in 13/226 males. Thyroid nodules were found in 27/482 subjects (18 females, 9 males). Single nodules were found in 17/464 subjects (3.66%) with a thyroid gland of normal volume and in 4/18 subjects (22.2%) with goiter (chi2=10.21; p=0.001). Multiple nodules were found in 3/464 subjects (0.6%) with a thyroid of normal volume and in 3/18 (16.6%) subjects with goiter (chi2=24.31; p<0.0001). The prevalence of thyroid nodules was significantly higher in females >35 yr than in those <34 yr (chi2=7.47; p=0.0062). A significant increase (>30%) of nodular volume was found in 5 subjects, while an increased number of nodules was found in 8. In conclusion, thyroid ultrasonography reveals the presence of thyroid nodules in a significant proportion of apparently thyroid disease-free subjects living in a borderline iodine-sufficient urban area. Incidentally discovered thyroid nodules are associated with goiter and are likely to progress in volume and number.

Citing Articles

Proportion of thyroid cancer and other cancers in the democratic republic of Congo.

Bukasa-Kakamba J, Bangolo A, Bayauli P, Mbunga B, Iyese F, Nkodila A World J Exp Med. 2023; 13(3):17-27.

PMID: 37396884 PMC: 10308319. DOI: 10.5493/wjem.v13.i3.17.

Risk Stratification of Thyroid Nodules: From Ultrasound Features to TIRADS.

Rago T, Vitti P Cancers (Basel). 2022; 14(3).

PMID: 35158985 PMC: 8833686. DOI: 10.3390/cancers14030717.

Management of Thyrotoxicosis Induced by PD1 or PD-L1 Blockade.

Brancatella A, Lupi I, Montanelli L, Ricci D, Viola N, Sgro D J Endocr Soc. 2021; 5(9):bvab093.

PMID: 34337277 PMC: 8317632. DOI: 10.1210/jendso/bvab093.

Elevated thyroglobulin level is associated with dysfunction of regulatory T cells in patients with thyroid nodules.

Hu Y, Li N, Jiang P, Cheng L, Ding B, Liu X Endocr Connect. 2019; 8(4):309-317.

PMID: 30822273 PMC: 6432874. DOI: 10.1530/EC-18-0545.

Evaluation of the natural course of thyroid nodules in patients with acromegaly.

Dogansen S, Salmaslioglu A, Yalin G, Tanrikulu S, Yarman S Pituitary. 2018; 22(1):29-36.

PMID: 30430336 DOI: 10.1007/s11102-018-0923-1.

References

Brander A, Viikinkoski P, Nickels J, Kivisaari L . Thyroid gland: US screening in a random adult population. Radiology. 1991; 181(3):683-7. DOI: 10.1148/radiology.181.3.1947082. View

Shimamoto K, Endo T, Ishigaki T, Sakuma S, Makino N . Thyroid nodules: evaluation with color Doppler ultrasonography. J Ultrasound Med. 1993; 12(11):673-8. DOI: 10.7863/jum.1993.12.11.673. View

Williams E, Doniach I, Bjarnason O, MICHIE W . Thyroid cancer in an iodide rich area: a histopathological study. Cancer. 1977; 39(1):215-22. DOI: 10.1002/1097-0142(197701)39:1<215::aid-cncr2820390134>3.0.co;2-#. View

Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F . The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab. 1999; 84(2):561-6. DOI: 10.1210/jcem.84.2.5508. View

Martino E, Loviselli A, Velluzzi F, Murtas M, Carta M, Lampis M . Endemic goiter and thyroid function in central-southern Sardinia. Report on an extensive epidemiological survey. J Endocrinol Invest. 1994; 17(8):653-7. DOI: 10.1007/BF03349681. View

Belfiore A, La Rosa G, Padova G, Sava L, Ippolito O, Vigneri R . The frequency of cold thyroid nodules and thyroid malignancies in patients from an iodine-deficient area. Cancer. 1987; 60(12):3096-102. DOI: 10.1002/1097-0142(19871215)60:12<3096::aid-cncr2820601240>3.0.co;2-v. View

Espinasse P . [Thyroid echography in chronic autoimmune lymphocytic thyroiditis]. J Radiol. 1983; 64(10):537-44. View

Tan G, Gharib H . Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997; 126(3):226-31. DOI: 10.7326/0003-4819-126-3-199702010-00009. View

Fenzi G, Giani C, Ceccarelli P, Bartalena L, Macchia E, Aghini-Lombardi F . Role of autoimmune and familial factors in goiter prevalence. Studies performed in a moderately endemic area. J Endocrinol Invest. 1986; 9(2):161-4. DOI: 10.1007/BF03348088. View

10.

Zelmanovitz F, Furtado A, Schmid H . Incidentally discovered papillary carcinoma of the thyroid: value of ultrasonographic follow-up. A case-report. J Endocrinol Invest. 2000; 23(4):251-4. DOI: 10.1007/BF03343717. View

11.

Wesche M, Wiersinga W, Smits N . Lean body mass as a determinant of thyroid size. Clin Endocrinol (Oxf). 1998; 48(6):701-6. DOI: 10.1046/j.1365-2265.1998.00400.x. View

12.

Laurberg P, Pedersen K, Hreidarsson A, Sigfusson N, Iversen E, Knudsen P . Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab. 1998; 83(3):765-9. DOI: 10.1210/jcem.83.3.4624. View

13.

GUTEKUNST R, Hafermann W, Mansky T, Scriba P . Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis. Acta Endocrinol (Copenh). 1989; 121(1):129-35. DOI: 10.1530/acta.0.1210129. View

14.

Vitti P, Rago T, Mancusi F, Pallini S, Tonacchera M, Santini F . Thyroid hypoechogenic pattern at ultrasonography as a tool for predicting recurrence of hyperthyroidism after medical treatment in patients with Graves' disease. Acta Endocrinol (Copenh). 1992; 126(2):128-31. DOI: 10.1530/acta.0.1260128. View

15.

Woestyn J, Afschrift M, SCHELSTRAETE K, Vermeulen A . Demonstration of nodules in the normal thyroid by echography. Br J Radiol. 1985; 58(696):1179-82. DOI: 10.1259/0007-1285-58-696-1179. View

16.

Tomimori E, Pedrinola F, Cavaliere H, Knobel M, Medeiros-Neto G . Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid. 1995; 5(4):273-6. DOI: 10.1089/thy.1995.5.273. View

17.

MORTENSEN J, WOOLNER L, Bennett W . Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab. 1955; 15(10):1270-80. DOI: 10.1210/jcem-15-10-1270. View

18.

VANDER J, Gaston E, DAWBER T . The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968; 69(3):537-40. DOI: 10.7326/0003-4819-69-3-537. View

19.

Konno N, Yuri K, Taguchi H, Miura K, Taguchi S, Hagiwara K . Screening for thyroid diseases in an iodine sufficient area with sensitive thyrotrophin assays, and serum thyroid autoantibody and urinary iodide determinations. Clin Endocrinol (Oxf). 1993; 38(3):273-81. DOI: 10.1111/j.1365-2265.1993.tb01006.x. View

20.

Mariotti S, Sansoni P, Barbesino G, Caturegli P, Monti D, Cossarizza A . Thyroid and other organ-specific autoantibodies in healthy centenarians. Lancet. 1992; 339(8808):1506-8. DOI: 10.1016/0140-6736(92)91265-a. View