Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland

Aim. Improve the effectiveness of diagnosis and the outcome of treatment of patients with nodular nontoxic lesions of the thyroid gland. Material and Methods. During the last five years 2552 patients aged 18-84 were examined and treated, of which 2087 (81.8%) are women and 465 (18.2%) are men. Th...

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Autores principales:	Ye.V. Pleshanov, A.M. Urbanovych, V.I. Kolomiytsev, Yu.P. Dovhan, R.D. Makar, M.R. Krasnyi, Kh.A. Moskva
Formato:	article
Lenguaje:	EN UK
Publicado:	Danylo Halytsky Lviv National Medical University 2019
Materias:	thyroid gland, thyroid hormones, thyroid nodule, symptoms, diagnosis, treatment Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/0451f45136874641b91af43c78c64ea4
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spelling	oai:doaj.org-article:0451f45136874641b91af43c78c64ea42021-11-10T19:49:51ZModern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland1029-42442415-330310.25040/aml2019.02.046https://doaj.org/article/0451f45136874641b91af43c78c64ea42019-09-01T00:00:00Zhttps://amljournal.com/index.php/journal/article/view/61https://doaj.org/toc/1029-4244https://doaj.org/toc/2415-3303Aim. Improve the effectiveness of diagnosis and the outcome of treatment of patients with nodular nontoxic lesions of the thyroid gland. Material and Methods. During the last five years 2552 patients aged 18-84 were examined and treated, of which 2087 (81.8%) are women and 465 (18.2%) are men. The initial diagnosis was nodular goiter. The final diagnosis was established by using ultrasonography, serum blood tests on the thyrotrophic hormone, thyroxin, thyronine, thyroglubulin, calcitonin, and antibodies' titre to the thyroid peroxidase. The diagnosis was confirmed with fine-needle aspirations and cytological conclusion for 412 patients, and for 326 patients, who were operated on, the diagnosis was verified histologically. Results and Discussion. According to the results of the surveys, including morphological, nodular and multi-nodular colloid goiter was revealed in 1866 (73.1%) patients (198 were operated), thyroid adenoma in 312 (12.2%) patients (51 were operated), thyroid cancer - 43 (1.7%) patients (all operated), chronic Hashimoto's thyroiditis - 326 (12.8%) patients (60 operated), Riedel's thyroiditis and de Quervain's thyroiditis - 5 (0.2%) (two operated). 327 (12.8%) patients had cystic nodules, and 7 (0.3%) patients had multi-nodular retrosternal goiter. For 11 (3.6%) patients with confirmed benign diagnosis of cystic goiter, sclerotherapy was performed. Hormonal suppressive therapy was prescribed for 317 patients, but only 96 (30.3%), according to the results of ultrasonography had a positive temporary effect. Conclusions. For patients with benign thyroid nodules, in the absence of indications for surgery, dynamic observation using ultrasonography and a complex of laboratory tests is recommended. A fine needle aspiration with cytological examination should be performed in the case of the increase of the nodule and suspicion of malignant tumor (TIRADS - 3-4). Surgical treatment is required for patients with malignant thyroid tumors, with large (>3.5 cm) nodules, patients with goiter with the signs of compression of the neck, as well as for patients with subclinical toxic adenoma.Ye.V. PleshanovA.M. UrbanovychV.I. KolomiytsevYu.P. DovhanR.D. MakarM.R. KrasnyiKh.A. MoskvaDanylo Halytsky Lviv National Medical Universityarticlethyroid gland, thyroid hormones, thyroid nodule, symptoms, diagnosis, treatmentMedicine (General)R5-920ENUKActa Medica Leopoliensia, Vol 25, Iss 2-3, Pp 46-57 (2019)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	thyroid gland, thyroid hormones, thyroid nodule, symptoms, diagnosis, treatment Medicine (General) R5-920
spellingShingle	thyroid gland, thyroid hormones, thyroid nodule, symptoms, diagnosis, treatment Medicine (General) R5-920 Ye.V. Pleshanov A.M. Urbanovych V.I. Kolomiytsev Yu.P. Dovhan R.D. Makar M.R. Krasnyi Kh.A. Moskva Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
description	Aim. Improve the effectiveness of diagnosis and the outcome of treatment of patients with nodular nontoxic lesions of the thyroid gland. Material and Methods. During the last five years 2552 patients aged 18-84 were examined and treated, of which 2087 (81.8%) are women and 465 (18.2%) are men. The initial diagnosis was nodular goiter. The final diagnosis was established by using ultrasonography, serum blood tests on the thyrotrophic hormone, thyroxin, thyronine, thyroglubulin, calcitonin, and antibodies' titre to the thyroid peroxidase. The diagnosis was confirmed with fine-needle aspirations and cytological conclusion for 412 patients, and for 326 patients, who were operated on, the diagnosis was verified histologically. Results and Discussion. According to the results of the surveys, including morphological, nodular and multi-nodular colloid goiter was revealed in 1866 (73.1%) patients (198 were operated), thyroid adenoma in 312 (12.2%) patients (51 were operated), thyroid cancer - 43 (1.7%) patients (all operated), chronic Hashimoto's thyroiditis - 326 (12.8%) patients (60 operated), Riedel's thyroiditis and de Quervain's thyroiditis - 5 (0.2%) (two operated). 327 (12.8%) patients had cystic nodules, and 7 (0.3%) patients had multi-nodular retrosternal goiter. For 11 (3.6%) patients with confirmed benign diagnosis of cystic goiter, sclerotherapy was performed. Hormonal suppressive therapy was prescribed for 317 patients, but only 96 (30.3%), according to the results of ultrasonography had a positive temporary effect. Conclusions. For patients with benign thyroid nodules, in the absence of indications for surgery, dynamic observation using ultrasonography and a complex of laboratory tests is recommended. A fine needle aspiration with cytological examination should be performed in the case of the increase of the nodule and suspicion of malignant tumor (TIRADS - 3-4). Surgical treatment is required for patients with malignant thyroid tumors, with large (>3.5 cm) nodules, patients with goiter with the signs of compression of the neck, as well as for patients with subclinical toxic adenoma.
format	article
author	Ye.V. Pleshanov A.M. Urbanovych V.I. Kolomiytsev Yu.P. Dovhan R.D. Makar M.R. Krasnyi Kh.A. Moskva
author_facet	Ye.V. Pleshanov A.M. Urbanovych V.I. Kolomiytsev Yu.P. Dovhan R.D. Makar M.R. Krasnyi Kh.A. Moskva
author_sort	Ye.V. Pleshanov
title	Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
title_short	Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
title_full	Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
title_fullStr	Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
title_full_unstemmed	Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
title_sort	modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland
publisher	Danylo Halytsky Lviv National Medical University
publishDate	2019
url	https://doaj.org/article/0451f45136874641b91af43c78c64ea4
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Modern approaches to the diagnosis and treatment of nodular nontoxic lesions of the thyroid gland

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