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Thyroid Diseases

How to Best Follow Thyroid Enlargement or Goiter

02/15/2007

Question:

I am a 20 year old female in good health. I recently went to the doctor with what I thought was a sinus infection. When he was assessing my head and neck, he noticed that my thyroid was enlarged. He did blood tests, which came back normal, and sent me for an ultrasound. The results were: rt. lobe 5.1*1.7*1.4cm, and left lobe 5.1*1.3*1.8 both with heterogenous echotexture, no discrete mass, and diffusely hypervascular. What does this mean? I have no other symptoms except for a little pressure in my neck. The doctor thinks it is thyroiditis caused by a viral infection. Are there any other tests that I should have done?

Answer:

The normal thyroid gland is 3-4 cm long and 1.5 - 2.0 cm wide, so this is really a very slight enlargement of the thyroid. Viral infections of the thyroid usually cause tenderness and decreased vascularity. Increased vascularity suggests an overactive thyroid but the blood tests didn't confirm this, so I'm not sure what to make of it.

Small goiters are pretty common and I doubt that this will turn out to be a health problem for you. It would probably be best for your doctor to check your thyroid blood tests and examine the thyroid periodically, at least for the next few years, to see if the thyroid grows or the blood tests become abnormal. As long as the blood tests are normal and the thyroid is not getting bigger I don't think you have anything to worry about.

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Response by:

Thomas A Murphy, MD, FACP, FACE Thomas A Murphy, MD, FACP, FACE
Associate Professor of Medicine
School of Medicine
Case Western Reserve University