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Biophilia Tracker X5 ULTRA and Thyroid Tumors

Thyroid diseases are mainly divided into two categories: medically treated thyroid diseases and surgically treated thyroid diseases. Thyroid diseases treated by medical treatment mainly include hyperthyroidism (commonly known as hyperthyroidism) and thyroid inflammation (including acute, subacute and chronic thyroid inflammation). Thyroid diseases treated surgically include goiters and thyroid tumors. The main difference between the two is that medically treated thyroid diseases have abnormal thyroid function tests, while surgically treated thyroid diseases have normal thyroid function tests. But the two are not absolutely isolated, and they can also transform into each other, especially medical thyroid disease may also require surgical treatment. This article mainly introduces four types of thyroid diseases, goiter, hyperthyroidism (hyperthyroidism), thyroid inflammation, and thyroid tumor.
With the Biophilia Tracker X5 ULTRA device, the thyroid gland can be examined to understand the condition and changes of the thyroid gland.
Benign thyroid tumors are mainly thyroid adenomas. Occurs mostly in young adults. Clinical manifestations are mostly anterior neck mass, slow growth, no symptoms. On physical examination, the mass was smooth, soft or tough in texture, with clear boundaries, and could move up and down with swallowing. Such as adenoma hemorrhage, the mass can increase rapidly, accompanied by local pain, these symptoms generally disappear within 1-2 weeks.
The general indicators of thyroid function test are all within the normal range, but if it is a high-functioning adenoma, T3, T4, FT3, FT4 can be increased, and TSH can be decreased. B-ultrasound examinations are mostly single nodules in the thyroid gland, but also multiple; they are solid or mixed, mostly oval, with clear borders, regular shapes, and there may be halo around them, and the blood supply may be rich.
Generally, thyroid adenomas with a diameter of less than 10mm are recommended to be observed and regularly followed up by B-ultrasound. Surgery may be considered if the adenoma has grown rapidly recently or has symptoms of compression, or has a tendency to become malignant during follow-up, or is diagnosed as a high-functioning adenoma.
Thyroid malignancy
1. Disease classification: It can be divided into differentiated thyroid cancer including papillary thyroid cancer and follicular thyroid cancer, poorly differentiated thyroid cancer such as medullary cancer and anaplastic thyroid cancer. At present, the incidence of thyroid cancer is increasing year by year.
2. Causes: The etiology of thyroid cancer is not very clear, it may be related to dietary factors (high iodine or iodine-deficient diet), history of radiation exposure, increased estrogen secretion, genetic factors, or other benign thyroid diseases such as nodular goiter , hyperthyroidism, thyroid adenoma, especially chronic lymphocytic thyroiditis evolved.
3. Clinical manifestations: Differentiated thyroid cancer is more common in women, and the common age is 30-60 years old. Differentiated thyroid cancer develops slowly, and the patient may find a gradually increasing painless mass in the neck, which is discovered accidentally by himself or during a physical examination, or during a B-ultrasound examination. Physical examination showed that the tumor was hard, with a smooth surface and a clear border. If the cancer is confined to the thyroid, it can move up and down with swallowing; if it has invaded the trachea or adjacent tissues, it is relatively fixed.
4. Auxiliary examination: The thyroid function test is mostly normal, but if it is transformed from other diseases such as hyperthyroidism or Hashimoto's thyroiditis, there is a corresponding abnormal thyroid function. Ultrasound is very helpful for the diagnosis of differentiated thyroid cancer. Differentiated thyroid carcinomas are mostly solid masses in B-ultrasound, but some can also be mixed masses with mainly solid components. Papillary thyroid carcinoma usually shows low or very low echo in B-ultrasound, micro calcification may appear in the parenchyma, the shape of the mass may be abnormally vertical or erect, and the blood supply around the mass is rich. Follicular thyroid carcinoma is mostly a very homogeneous hyperechoic mass with rich blood supply in B-ultrasound. The size of the mass, whether the boundary is clear, and whether the shape is regular are not important indicators for judging whether the mass is malignant. Now preoperatively, fine needle aspiration cytology (FNA) is performed on the mass suspected of malignancy under B-ultrasound localization, which can further confirm the diagnosis of thyroid cancer.
Generally differentiated thyroid cancers are mostly cold nodules on isotope scans. If differentiated thyroid cancer is suspected to have lymph node metastasis or invasion of surrounding organs such as trachea and esophagus, CT examination can be used to understand the extent of lymph node metastasis and the degree of invasion to trachea, esophagus and other organs, so as to facilitate the formulation of surgical plans.
5. Disease treatment:
① Papillary thyroid cancer: mostly lymph node metastasis. Lymph nodes in the neck can be divided into areas I-VI, generally II-VI lymph nodes are related to the metastasis of thyroid cancer. Usually, level VI lymph nodes are also called central group lymph nodes, including tracheoesophageal groove, pretracheal, and prelaryngeal lymph nodes; level II-V lymph nodes are also called lateral cervical lymph nodes, including lymph nodes around great vessels in the neck and lymph nodes around accessory nerves. Because the central lymph nodes are mostly located behind the thyroid gland and have a small diameter, it is generally difficult to detect by cervical ultrasound; while the lateral cervical lymph nodes can be detected by B ultrasound to find out whether there is metastasis. In most cases, papillary thyroid cancer on one side usually metastasizes to the lymph nodes on the same side, but it can also metastasize to the lymph nodes on the opposite side. The way of lymph node metastasis is generally to first transfer to the central lymph nodes, and then transfer to the lateral cervical lymph nodes; but there are also individual cancers such as tumors located in the upper pole of the thyroid can first transfer to the lateral cervical lymph nodes. It has been reported in the literature that, regardless of the size of the tumor, the lymph node metastasis rate in the central group usually reaches about 50%. In view of this, the latest guidelines for differentiated thyroid cancer in my country emphasize the dissection of central lymph nodes. However, for the scope of thyroidectomy, an individualized plan can be implemented according to the stage of the tumor, the medical conditions in various places, and the patient's degree of awareness of the disease, but at least the lobe + isthmus of the cancerous side must be removed.
②Follicular thyroid carcinoma: It usually metastasizes to the lung, bone, brain, liver and other organs through blood. A more reasonable surgical plan is to perform bilateral total/subtotal resection of the thyroid gland and dissection of the central group lymph nodes on the affected side. Iodine 131 treatment. However, due to the difficulty in identifying follicular carcinoma in intraoperative frozen pathological sections, additional surgery is often required.
According to foreign experience, due to the better prognosis of differentiated thyroid cancer, if the surgical resection is complete, it should be supplemented with iodine-131 consolidation therapy after surgery. After the end of iodine treatment, lifelong use of thyroxine preparations for suppressive therapy can often achieve the effect of radical cure. However, for differentiated thyroid cancer with more residual thyroid after surgery, iodine therapy cannot achieve the effect of consolidation therapy, and discontinuation of thyroxine preparations during repeated iodine therapy may cause tumor recurrence or dedifferentiation. For patients with more residues, it is recommended to take thyroxine preparations for suppressive therapy. The dose of thyroxine suppression therapy varies from person to person according to the stage of the tumor.
③Medullary thyroid carcinoma: It is a moderate malignant tumor that occurs in thyroid C cells. It can be divided into sporadic, familial and MEN2 types. The main manifestations of the patient are painless hard solid nodules of the thyroid gland and regional lymphadenopathy. Sometimes swollen lymph nodes become the first symptom. Some patients with medullary thyroid cancer may experience diarrhea, abdominal pain, and flushing. On physical examination, the goiter was hard, with ill-defined borders and an uneven surface. Sporadic thyroid tumors are mostly unilateral, while familial and MEN2 types can be bilateral thyroid tumors.
Serum calcitonin levels were elevated in patients with medullary thyroid cancer, and carcinoembryonic antigen (CEA) levels were also elevated in some patients. B-ultrasound showed that the mass was mostly located in the upper half of the thyroid, which could be single or multiple, showing hypoechoic, calcification in the center of the mass, and no halo in the nodule, with abundant blood supply.
Medullary thyroid cancer can have early lymph node metastasis and distant metastasis through blood, so the prognosis is worse than differentiated thyroid cancer. Since medullary carcinoma is ineffective against thyroxine preparations and iodine-131 treatment, only surgery is the most effective treatment for medullary carcinoma. The scope of surgical resection should include bilateral total thyroidectomy and lymph node dissection in the central group of the cancer side. However, for familial medullary carcinoma, prophylactic lateral cervical lymph node dissection can be performed even if no lateral cervical lymph node metastasis is found. Because of the loss of thyroid function after medullary carcinoma surgery, thyroxine preparations must be given for replacement therapy.
④Anaplastic thyroid carcinoma: It is a highly malignant tumor and is more common in elderly patients, generally over 65 years old. The vast majority of patients present with a sudden onset of a neck mass that is firm, uneven, ill-defined, poorly mobile, and rapidly increasing. May be accompanied by hoarseness, difficulty breathing and swallowing, and local lymphadenopathy may be present. On ultrasonography, it appears as a heterogeneous mass with ill-defined boundaries, often involving the entire glandular lobe or gland. Necrotic areas are present in most cases.
Due to the high degree of malignancy of anaplastic thyroid cancer, the disease progresses very rapidly, and it is easy to invade surrounding organs and tissues, such as the trachea, esophagus, and nerves and blood vessels in the neck. Treatment and chemotherapy, thyroid isthmectomy or tracheotomy only if the airway is compressed or blocked. In recent years, some people advocate that for early anaplastic thyroid cancer, if the primary tumor is small, lobectomy or total thyroidectomy can be performed, and postoperative adjuvant radiation and chemotherapy can also achieve good results.
Therefore, in our life, we can be equipped with a set of Biophilia Tracker X5 ULTRA equipment to understand physical health, prevent various diseases, and make our lives healthier.