thyroid cyst - a disease characterized by the appearance of the organ tissue benign tumor-like formations filled with a homogeneous colloidal content (colloid cyst of the thyroid gland) and dense formation (complex or complicated cysts).
These conditions are also called nodes and thyroid cysts.Their difference is that the cyst cavity is filled with liquid, while the nodes consist of actually modified glandular cells.Dimensions cysts often are small (less than 1 cm), but may rise significantly, and this can occur rapidly.
At considerable sprawl brush and set it in the dense elements necessary to conduct a special survey on the presence of a malignant tumor.In this case, the doctor will prescribe a biopsy of the cyst components.
In the structure of morbidity of the population, the incidence of cysts is 1-5% of the total number of patients with impaired function of the gland.
Causes of cysts
Simple cysts may be the result of exposure to a variety of factors, from a simple viral infection to cancer due to blockage of the duct structure of individual organ anatomy.With the development of infectious diseases accompanied by inflammation of the gland, a cyst can develop as a secondary symptom.
Complex cysts contain fluid and dense particles and have similar symptoms with colloidal formations.Risk factors and cysts causes thyroid include:
- Oncological diseases, radiation and chemotherapy
- cyst may be formed as a result of hemorrhage
- eating disorders (dystrophy) gland
- As a result of an increase in its follicles
- If insufficient intake of iodinefood
- Autoimmune diseases accompanied by inflammatory changes in the prostate (Hashimoto's)
- Radiation exposure in childhood
- Female sex
- Age older than 40 years
- presence of thyroid cysts parents, brothers or sisters.
- cysts in the thyroid gland in women found in 4 times more often than men.
- more prone to this disease the inhabitants of regions with insufficient iodine in food and water.
- In patients undergoing exposure to ionizing radiation for 1 calendar year, cyst of the thyroid gland develops in 2% of cases.
symptoms of thyroid cyst
Patients with cysts of small size (up to 3 mm) does not note any symptoms of the disease and feel perfectly healthy people.Most of them know about the disease only after identifying their physician during the inspection.As the size of the thyroid gland cysts symptoms become more pronounced.The first manifestation of progressive cyst is a "lump" in his throat.It is also the first time a cyst can be suspected by the appearance of increased education on the neck, which is easily detectable through the skin.Other common symptoms include:
- Shortness of breath (due to compression of the trachea cyst);
- Pain in the breast area can spread to the jaw and ear;
- pain when swallowing or inability to swallow food;
- changes in voice (is rare, due to the compression of the enlarged cyst specific nerve fibers).
in the development of the disease distinguish several stages:
- step of forming the cysts.Asymptomatic.The disease at this stage is found incidentally during routine inspection;
- stage of growth.When congestion large volume of liquid in the cyst cavity gradually increases its size, which leads to the development of characteristic symptoms.Have your doctor may suspect the disease is already at a visual inspection.The diagnosis is easily confirmed by means of laboratory tests;
- Stage resorption.When a satisfactory condition of the immune system disease is their own, and the cyst undergoes scarring, without causing serious disorders of the body state.
When malignant disease course cysts may degenerate into cancer.Such formations have a dense consistency and their rapid uncontrolled growth.It is also seen that for malignant disease often accompanied by a change of voice due to the rapid growth of cysts.
A common concomitant symptom of the disease is a dysfunction of the thyroid, characterized by an increase or decrease in hormone production.As a result of abnormalities in the gland at progressive course of the disease, patients have chronic fatigue, weight loss, deterioration of immunity.With the development of these symptoms should undergo further investigation for the presence of malignant cancer process.
When complicated course of cysts in the altered tissue edema appears and the development of bacterial flora, which leads to inflammatory changes and accumulation of pus.Symptoms of infection are joined growing acute pain in the neck, swelling, fever.A typical symptom is an increase in cervical lymph nodes.
main method of diagnosis - a visualization using ultrasound.Using ultrasound determined size, structure and cyst surrounding healthy tissues.This method makes it possible not only to accurately diagnose a cyst, but also make a differential diagnosis with adenoma, nodular goiter and other diseases.
cyst biopsy is performed to determine the type of cyst and exclude malignancy.When taking a biopsy uses a thin needle, which is held in the cyst under ultrasound guidance.The procedure is not particularly difficult and is performed under local anesthesia.For a more accurate diagnosis of the taking of the material it is made from multiple cysts of various departments or cysts.By the nature of the cyst contents obtained by biopsy, is judged on its type:
- yellow, purple or dark brown color of the liquid in the cyst indicates uncomplicated;
- presence of pus in the cyst shows join inflammation.
samples were investigated microscopically to check for cancer cells.Cyst of thyroid tumors characterized by the presence of glandular cells unchanged.These results are obtained in 60% of cases.
for Malignant confirmed by biopsy in 5% of cases.Border result noted in 20% of cases.Thus the majority of patients during the second study, the cancer cells are detected.If insufficient quantities of material taken study biopsy is uninformative and requires re-examination.
cyst puncture may be accompanied by its complete emptying followed by introduction into the cavity of sclerosing agents.This method can significantly reduce the number of surgical procedures and to achieve recovery at an early stage.The puncture is performed under ultrasound, which provides a low percentage of unsuccessful attempts and injury to healthy tissue.In the analysis of the contents of the cyst special attention paid to the presence of atypical cells, pointing to the development of malignant cancer process.
as additional methods are used:
- CT scan to determine the structure of large cysts;
- angiography to prevent vascular complications;
- Laryngoscopy with the appearance of hoarseness or other voice changes;
- bronchoscopy to assess the condition of the trachea at Pumping cysts to large size;
- control thyroid hormone levels.
How to treat thyroid cyst?
Effective treatment of benign thyroid cyst is drained by puncture followed by sclerosing agents.This non-invasive procedure that can be performed again at relapse.
Provided that detected a cyst is not a malignancy, held conservative therapy.Destinations include the use of:
- preparations for the regulation of thyroid hormones,
- as well as anti-inflammatory, metabolic
- and improve blood circulation to reduce swelling and reduce the brush size.
Antibiotic therapy is conducted upon accession infection and requires an accurate identification of the type of pathogen and determine its sensitivity to antimicrobial drugs.Drug therapy is more effective in the early stages of the disease and can significantly reduce the incidence of surgical interventions.Only the doctor determines how to treat a cyst in the thyroid gland of each individual patient.
When surgical treatment?
- With progressive growth of cysts or accession if symptoms of respiratory disorders and difficulty in swallowing the treatment of choice is surgical treatment of thyroid cysts.
- When cysts increased risk of transition into a malignant tumor, or in the presence of confirmed laboratory data operation is performed immediately, regardless of the stage of disease and the size of the cyst.In this case, conservative treatment is not carried out, as is more likely the deterioration of the patient and the development of severe cancer.
Delete if the cyst?
Although most thyroid cyst cases are benign, but their "behavior" is unpredictable:
- In some cases, they have over the years do not give negative dynamics
- Other - soaring
- Thirdly - are themselves
- Usuallyreason for seeking medical attention - to the size of the cyst growth (over 3 cm), visible to the eye and causing deformation of the neck, hoarseness or loss, lump in the throat, breathing and swallowing function disorder, pain in the neck.
If the cyst with a diameter less than 1 cm -this her only watch its increase carried out a puncture with cytology.If after emptying the cyst in her again accumulates the content, the question of its removal.No warm-up compresses or lotions on the hands to put in any case can not, because it can cause inflammation.
Surgical treatment of malignant course usually includes bilateral resection of the thyroid gland (removing most of its share of both).After this operation, it is sure to closely monitor the level of thyroid hormones and, if necessary, appointed its correction by means of medical hormones (thyroid hormone).
frequent complication of this operation is a violation of vocal cord function with partial loss of voice.If a patient is diagnosed cyst left lobe of the thyroid gland, the operation is carried out only on the affected side (the same is the case with a lesion of the right lobe).Removing the thyroid cysts performed through a small incision in the neck in the thyroid gland.
Remote education is subjected to histological examination to confirm a benign process.This allows you to carefully plan further treatment.
postoperative course was easy.Returning to normal life occurs within 1-2 days, without the need for physical activity limitations.
The peculiarities of treatment in pregnant women include the exclusion of radiological methods.A biopsy and surgical treatment during pregnancy is not contraindicated.When planning treatment must take into account the relative risks and benefits.If there are clear indications operation is recommended in the second trimester of pregnancy.In the absence of expressed symptoms of compression of adjacent organs or thyroid dysfunction treatment is carried out in the postpartum period.
cysts with benign course, have a positive outlook, and with proper treatment are no consequences for the patient.In many cases, patients do not even need to be treated.Suffice it to conduct control tests in the dynamics.
more severe course and prognosis for the life of the patient has a malignant course, where the cyst is degenerating into cancer.Risk of malignancy is also improved in the case of thyroid cyst diagnosed child (14-40% of cases, compared with 5% in adults).
percentage of the effectiveness of treatment in patients with malignant course of the disease is about 80% in the early stages and significantly reduced the development of metastasis and tumor invasion into nearby organs.