Clinical manifestations of nodular goiter

1. The patient has a long history of simple goiter. The onset age is generally over 30 years old. There are more women than men. The degree of goiter is different and asymmetrical. The number and size of nodules vary, usually multiple nodules, and there may be only one nodule in the early stage. Nodules are soft or slightly hard, smooth and without tenderness. Sometimes the nodule boundary is unclear, and only the feeling of irregularity or lobulation is felt when touching the thyroid surface. The disease progresses slowly and most patients are asymptomatic. Larger nodular goiter can cause compression symptoms such as dyspnea, dysphagia and hoarseness. Acute hemorrhage in the nodule can cause sudden enlargement and pain of the mass, the symptoms can subside within a few days, and the enlarged mass can shrink within a few weeks or longer.

2. Nodular goiter with hyperthyroidism (plummer's disease), patients have symptoms such as fatigue, weight loss, palpitation, arrhythmia, fear of hyperhidrosis and irritability, but there is no vascular murmur and tremor in thyroid gland, and exophthalmos and finger tremor are rare. The symptoms of elderly patients are often atypical.

3. Whether the patient has a history of radiotherapy, oral medication and family history, and whether the area where the patient comes from is an endemic goiter area. Generally, nodular goiter has a long history and no symptoms of oppression and hyperthyroidism, so patients often don't care. They came across thyroid nodules and came to see a doctor for examination.

4. If it is a hot nodule, also known as toxic nodule, the patients are mostly over 40 to 50 years old, with moderate hardness, hyperthyroidism symptoms and even arrhythmia manifestations such as atrial fibrillation. If there is bleeding, there may be pain or even fever. When the nodule is large, there may be compression symptoms, such as dysphonia, dyspnea, chest tightness, shortness of breath, irritating cough, etc.

5. For example, patients with nodular goiter from iodine-deficient areas may have symptoms such as hypothyroidism, slow heart rate, edema, rough skin and anemia. A few patients may also become cancerous. Nodules with warm nature are common and can be treated with thyroid preparations, and swollen glands can be reduced. Cold nodules are rare, and clinical hypothyroidism can be treated with thyroid preparations, but surgery is often needed.