Thyroid 2.0

• what's the most common cause of hyperthyroidism?

  graves' disease
• graves' disease occurs most frequently in women greater than 30 years old
• graves' disease sono findings

  • echotexture normal to heterogenous
  • younger patient thyroid are hypoechoic
  • "thyroid inferno"
  • velocities over 70 cm/sec
• name the pathology

  ?

  A) graves' disease

  
• thyroid stimulating hormone (TSH) aka thyrotropin
• high frequency (7.5 to 15 MHz) linear array transducer should be used for thyroid u/s
• 19% of US population has a palpable thyroid nodule
• what's acute suppurative thyroiditis?

  • uncommon bacterial infection
  • causes hypervascularity
  • enlarged heterogenous gland
• what's subacute (de Quervain’s) thyroiditis?

  • viral infection of the thyroid
  • acute or chronic onset
  • may cause transient hyperthyroidism
  • enlarged hypoechoic gland
  • normal or decreased vascularity
• name the pathology

  ?

  A) acute suppurative thyroiditis

  
• name the pathology

  ?

  A) subacute (de Quervain's) thyroiditis

  
• symptoms for subacute (de Quervain's) thyroiditis

  • dysphagia
  • pain
  • fever
  • enlargement
  • malaise
• what's the most common form of thyroiditis?

  hashimoto's
• what's hashimoto's thyroiditis?

  • destructive autoimmune disorder
  • leads to chronic inflammation
  • diffuse enlargement
  • not always symmetric
• hashimoto's usually develops in young to middle aged women
• hashimoto's sono findings

  • heterogenous echotexture
  • slightly more hypoechoic than norm
  • initially, uniform enlargement with nodules
  • as disease progresses, gland shows heterogenous enlargement with small nodules
  • enlarged hyperemic lymph nodes
  • "thyroid inferno"
• name the pathology

  ?

  A) hashimoto's thyroiditis

  
• list the 3 terms to describe a goiter

  • nodular hyperplasia
  • multinodular goiter
  • adenomatous hyperplasia
• what is the most common thyroid abnormality?

  goiter
• goiters are most commonly caused by what?

  iodine deficiency
• what's toxic goiter?

  enlargement that causes hyperthyroidism
• what's non toxic goiter?

  enlargement that is not associated with thyroid dysfunction
• goiter sono findings

  • nodules are isoechoic to normal thyroid tissue
  • as gland enlarges, become hyperechoic
  • area of scarring, ischemia, necrosis, and cyst formation are common followed by fibrosis and/or calcifications
• name the pathology

  ?

  A) goiter

  
• name the pathology

  ?

  A) goiter

  
• purely anechoic cysts are composed of serous or colloid fluid
• echogenic fluid, debris or distinctive fluid levels correspond to hemorrhagic cyst
• approx. 20% of solitary nodules are cystic
• name the pathlogy

  ?

  A) anechoic cyst

  
• name the pathology

  ?

  A) colloid cyst

  
• name the pathology

  ?

  A) hemorrhagic cyst

  
• what's an adenoma?

  • benign thyroid neoplasm with complete fibrous encapsulation and compression of adjacent tissue
• adenoma sono findings

  • homogenous echotexture
  • slow growing
  • usually solitary w/ areas of necrosis and hemorrhage
  • anechoic to completely hyperechoic and commonly have peripheral halo (echogenic)
  • hyperfunction of adenoma shows increased blood flow
  • with doppler, flow along the peripheral borders or within the lesion is common
• name the pathlogy

  ?

  A) adenoma

  
• name the pathology

  ?

  A) adenoma

  
• carcinoma of thyroid is rare
• risk of malignancy decreases with presence of multiple nodules
• solitary thyroid nodule in presence of cervical adenopathy on the ipsilateral side suggests malignancy
• malignant lesions are associated with:

  • Painless, palpable, and hard solitary nodule
• if malignant lesion is more advanced--

  • Compression of adjacent structures causing:
  • Dyspnea
  • Dysphagia
  • Coughing
  • Hoarseness