eMedicine Specialties > Radiology > Head/Neck

Thyroid Nodules: Multimedia

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP, Chairman of Medical Imaging, Professor of Radiology, NGHA, King Fahad National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Coauthor(s): Yousif Al-Khattab, MBChB, DMRD, FRCR, Consulting Staff, Department of Radiology, North Manchester Healthcare Trust, UK; Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Contributor Information and Disclosures

Updated: Jan 22, 2009

Multimedia

(Enlarge Image)

Media file 1: Coned apical radiograph of the upper thorax shows curvilinear calcification in a thyroid adenoma, at the root of the neck, on the right side.

[ CLOSE WINDOW ]

Coned apical radiograph of the upper thorax shows curvilinear calcification in a thyroid adenoma, at the root of the neck, on the right side.

(Enlarge Image)

Media file 2: Posteroanterior chest radiograph shows a large retrosternal goiter (G) that displaces the trachea to the left (arrow).

[ CLOSE WINDOW ]

Posteroanterior chest radiograph shows a large retrosternal goiter (G) that displaces the trachea to the left (arrow).

(Enlarge Image)

Media file 3: Plain anteroposterior radiograph of the neck shows punctate calcification to the right of the cervical spine (straight arrow) and further multiple conglomerates of calcification at the root of the neck (curved arrow), also on the right.

[ CLOSE WINDOW ]

Plain anteroposterior radiograph of the neck shows punctate calcification to the right of the cervical spine (straight arrow) and further multiple conglomerates of calcification at the root of the neck (curved arrow), also on the right.

(Enlarge Image)

Media file 4: Standard posteroanterior chest radiograph (in the same patient as in Image 3) shows widening of the superior mediastinum on the right in a lobulated fashion.

[ CLOSE WINDOW ]

Standard posteroanterior chest radiograph (in the same patient as in Image 3) shows widening of the superior mediastinum on the right in a lobulated fashion.

(Enlarge Image)

Media file 5: Plain radiograph of the upper abdomen (in the same patient as in Images 3-4) shows multiple conglomerates of punctate calcification in the right hypochondrium encroaching on the left hypochondrium. The final diagnosis was a medullary carcinoma of the thyroid (calcified), lymph node metastases at the root of the neck (calcified), right superior mediastinal metastases, and gross hepatomegaly with multiple calcified hepatic metastases.

[ CLOSE WINDOW ]

Plain radiograph of the upper abdomen (in the same patient as in Images 3-4) shows multiple conglomerates of punctate calcification in the right hypochondrium encroaching on the left hypochondrium. The final diagnosis was a medullary carcinoma of the thyroid (calcified), lymph node metastases at the root of the neck (calcified), right superior mediastinal metastases, and gross hepatomegaly with multiple calcified hepatic metastases.

(Enlarge Image)

Media file 6: Posteroanterior chest radiograph shows a large, lytic, expanding metastasis in the anterior aspects of the right fifth and sixth ribs, secondary to an anaplastic thyroid carcinoma in an 85-year-old woman. Note displacement of the trachea to the left by a mass lesion at the root of the neck.

[ CLOSE WINDOW ]

Posteroanterior chest radiograph shows a large, lytic, expanding metastasis in the anterior aspects of the right fifth and sixth ribs, secondary to an anaplastic thyroid carcinoma in an 85-year-old woman. Note displacement of the trachea to the left by a mass lesion at the root of the neck.

(Enlarge Image)

Media file 7: Anteroposterior chest radiograph of an 86-year-old woman who had been unwell for a few months and was losing weight. The radiograph shows a right superior mediastinal mass.

[ CLOSE WINDOW ]

Anteroposterior chest radiograph of an 86-year-old woman who had been unwell for a few months and was losing weight. The radiograph shows a right superior mediastinal mass.

(Enlarge Image)

Media file 8: Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass (m) at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (same patient as in Image 7).

[ CLOSE WINDOW ]

Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass (m) at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (same patient as in Image 7).

(Enlarge Image)

Media file 9: Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass (m) at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (same patient as in Images 7-8).

[ CLOSE WINDOW ]

Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass (m) at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (same patient as in Images 7-8).

(Enlarge Image)

Media file 10: Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (arrow) (same patient as in Images 7-9).

[ CLOSE WINDOW ]

Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (arrow) (same patient as in Images 7-9).

(Enlarge Image)

Media file 11: Computed tomography scan shows a mass in the posterior mediastinum (P), which displaces the air-filled esophagus to the right (arrow) (same patient as in Images 7-10).

[ CLOSE WINDOW ]

Computed tomography scan shows a mass in the posterior mediastinum (P), which displaces the air-filled esophagus to the right (arrow) (same patient as in Images 7-10).

(Enlarge Image)

Media file 12: Iodine-123 thyroid scan shows that a mass is a multinodular goiter (G). The posterior mediastinal mass is a hiatus hernia (H); the stomach (S) is shown. Further investigation revealed that thyrotoxicosis was the cause of the patient's symptoms (same patient as in Images 7-11).

[ CLOSE WINDOW ]

Iodine-123 thyroid scan shows that a mass is a multinodular goiter (G). The posterior mediastinal mass is a hiatus hernia (H); the stomach (S) is shown. Further investigation revealed that thyrotoxicosis was the cause of the patient's symptoms (same patient as in Images 7-11).

(Enlarge Image)

Media file 13: Technetium-99m pertechnetate thyroid scan demonstrates normal findings in a thyroid gland.

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan demonstrates normal findings in a thyroid gland.

(Enlarge Image)

Media file 14: Technetium-99m pertechnetate thyroid scan demonstrates an autonomous nodule with increased activity. Uptake in the remainder of the thyroid is suppressed.

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan demonstrates an autonomous nodule with increased activity. Uptake in the remainder of the thyroid is suppressed.

(Enlarge Image)

Media file 15: Technetium-99m pertechnetate thyroid scan demonstrates intense activity in a large thyroid gland in a patient who was hypothyroid. The patient had Pendred syndrome. Note the pyramidal lobe (P).

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan demonstrates intense activity in a large thyroid gland in a patient who was hypothyroid. The patient had Pendred syndrome. Note the pyramidal lobe (P).

(Enlarge Image)

Media file 16: Technetium-99m pertechnetate thyroid scan demonstrates a thyrotoxic goiter. Note the pyramidal lobe (arrow).

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan demonstrates a thyrotoxic goiter. Note the pyramidal lobe (arrow).

(Enlarge Image)

Media file 17: Technetium-99m pertechnetate thyroid scan demonstrates a multinodular goiter.

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan demonstrates a multinodular goiter.

(Enlarge Image)

Media file 18: Technetium-99m pertechnetate thyroid scan demonstrates a cold nodule in the left lobe of the thyroid (C).

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan demonstrates a cold nodule in the left lobe of the thyroid (C).

(Enlarge Image)

Media file 19: Technetium-99m pertechnetate thyroid scan shows a photon-deficient mass in the upper pole of the left lobe in a 53-year-old woman with a sudden onset of pain in the anterior aspect of the neck.

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan shows a photon-deficient mass in the upper pole of the left lobe in a 53-year-old woman with a sudden onset of pain in the anterior aspect of the neck.

(Enlarge Image)

Media file 20: Sonogram demonstrates a multilocular benign cyst (same patient as in Image 19).

[ CLOSE WINDOW ]

Sonogram demonstrates a multilocular benign cyst (same patient as in Image 19).

(Enlarge Image)

Media file 21: Repeat 3-month follow-up sonogram in a 53-year-old woman with a sudden onset of pain in the anterior part of the neck shows that the septa have resolved. However, debris and strands are noted at the bottom of the cyst (same patient as in Images 19-20).

[ CLOSE WINDOW ]

Repeat 3-month follow-up sonogram in a 53-year-old woman with a sudden onset of pain in the anterior part of the neck shows that the septa have resolved. However, debris and strands are noted at the bottom of the cyst (same patient as in Images 19-20).

(Enlarge Image)

Media file 22: Further 3-month follow-up sonogram shows a considerable reduction in the size of the cyst, with a tiny debris level at the base of the cyst, in a 53-year-old woman with a sudden onset of pain in the anterior part of the neck. The final diagnosis was hemorrhage in a benign cyst (same patient as in Images 19-21).

[ CLOSE WINDOW ]

Further 3-month follow-up sonogram shows a considerable reduction in the size of the cyst, with a tiny debris level at the base of the cyst, in a 53-year-old woman with a sudden onset of pain in the anterior part of the neck. The final diagnosis was hemorrhage in a benign cyst (same patient as in Images 19-21).

(Enlarge Image)

Media file 23: Sonogram demonstrates a cystic colloid cyst with a comet tail artifact, in the thyroid.

[ CLOSE WINDOW ]

Sonogram demonstrates a cystic colloid cyst with a comet tail artifact, in the thyroid.

(Enlarge Image)

Media file 24: Sonogram demonstrates a benign cystic lesion in the thyroid, with a surrounding halo and ragged walls.

[ CLOSE WINDOW ]

Sonogram demonstrates a benign cystic lesion in the thyroid, with a surrounding halo and ragged walls.

(Enlarge Image)

Media file 25: Sonogram demonstrates a multilocular benign cyst in the thyroid.

[ CLOSE WINDOW ]

Sonogram demonstrates a multilocular benign cyst in the thyroid.

(Enlarge Image)

Media file 26: Sonogram demonstrates thyroid cystic lesions in a 13-year-old female adolescent with cystic papillary thyroid carcinoma.

[ CLOSE WINDOW ]

Sonogram demonstrates thyroid cystic lesions in a 13-year-old female adolescent with cystic papillary thyroid carcinoma.

(Enlarge Image)

Media file 27: Technetium-99m pertechnetate thyroid scan shows a large cold nodule in the left lobe of the thyroid and a further, smaller cold nodule in right lobe.

[ CLOSE WINDOW ]

Technetium-99m pertechnetate thyroid scan shows a large cold nodule in the left lobe of the thyroid and a further, smaller cold nodule in right lobe.

(Enlarge Image)

Media file 28: Sonogram shows a 4-cm, hypoechoic, left-lobe thyroid mass (in the same patient as in Image 27).

[ CLOSE WINDOW ]

Sonogram shows a 4-cm, hypoechoic, left-lobe thyroid mass (in the same patient as in Image 27).

(Enlarge Image)

Media file 29: Sonogram displaying a palpable, asymptomatic thyroid nodule (same patient as in Images 27-28) shows a solid mass in the thyroid, with a completely surrounding halo. The final diagnosis was a follicular carcinoma of the left lobe and a benign adenoma of the right lobe.

[ CLOSE WINDOW ]

Sonogram displaying a palpable, asymptomatic thyroid nodule (same patient as in Images 27-28) shows a solid mass in the thyroid, with a completely surrounding halo. The final diagnosis was a follicular carcinoma of the left lobe and a benign adenoma of the right lobe.

(Enlarge Image)

Media file 30: Image in a patient with a palpable, asymptomatic thyroid nodule shows a solid mass in the left lobe, with a complete surrounding halo (thyroid adenoma).

[ CLOSE WINDOW ]

Image in a patient with a palpable, asymptomatic thyroid nodule shows a solid mass in the left lobe, with a complete surrounding halo (thyroid adenoma).

(Enlarge Image)

Media file 31: Power Doppler sonogram shows peripheral vascularity but no detectable flow in the tumor. The final diagnosis was benign thyroid adenoma (same patient as in Image 30).

[ CLOSE WINDOW ]

Power Doppler sonogram shows peripheral vascularity but no detectable flow in the tumor. The final diagnosis was benign thyroid adenoma (same patient as in Image 30).

(Enlarge Image)

Media file 32: A 56-year-old man underwent subtotal thyroidectomy for a familial medullary carcinoma 2 years previously. On routine follow-up examination, a mass was felt in the thyroid. Coronal, T1-weighted magnetic resonance imaging scan shows a carcinoma recurrence (R) and lymph node (L) metastases.

[ CLOSE WINDOW ]

A 56-year-old man underwent subtotal thyroidectomy for a familial medullary carcinoma 2 years previously. On routine follow-up examination, a mass was felt in the thyroid. Coronal, T1-weighted magnetic resonance imaging scan shows a carcinoma recurrence (R) and lymph node (L) metastases.

(Enlarge Image)

Media file 33: A 56-year-old man underwent subtotal thyroidectomy for a familial medullary carcinoma 2 years previously (same patient as in Image above). On routine follow-up examination, a mass was felt in the thyroid. Coronal, short-tau inversion recovery magnetic resonance imaging scan shows carcinoma recurrence (R) and lymph node (L) metastases.

[ CLOSE WINDOW ]

A 56-year-old man underwent subtotal thyroidectomy for a familial medullary carcinoma 2 years previously (same patient as in Image above). On routine follow-up examination, a mass was felt in the thyroid. Coronal, short-tau inversion recovery magnetic resonance imaging scan shows carcinoma recurrence (R) and lymph node (L) metastases.

More on Thyroid Nodules

Overview: Thyroid Nodules

Imaging: Thyroid Nodules

Follow-up: Thyroid Nodules

Multimedia: Thyroid Nodules

References

McNeil C. Annual cancer statistics report raises key questions. J Natl Cancer Inst. Nov 15 2006;98(22):1598-9.
Wiersinga WM. Thyroid cancer in children and adolescents—consequences in later life. J Pediatr Endocrinol Metab. 2001;14 Suppl 5:1289-96; discussion 1297-8.
Bruneton JN, Balu-Maestro C, Marcy PY, et al. Very high frequency (13 MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules. J Ultrasound Med. Feb 1994;13(2):87-90.
Nabriski D, Ness-Abramof R, Brosh TO, et al. Clinical relevance of non-palpable thyroid nodules as assessed by ultrasound-guided fine needle aspiration biopsy. J Endocrinol Invest. Jan 2003;26(1):61-4.
Daumerie C, Ayoubi S, Rahier J, et al. [Prevalence of thyroid cancer in hot nodules]. Ann Chir. 1998;52(5):444-8.
Mandel SJ. Diagnostic use of ultrasonography in patients with nodular thyroid disease. Endocr Pract. May-Jun 2004;10(3):246-52.
Miki H, Oshimo K, Inoue H, et al. Incidence of ultrasonographically-detected thyroid nodules in healthy adults. Tokushima J Exp Med. Jun 1993;40(1-2):43-6.
Brander A, Viikinkoski P, Nickels J, et al. Thyroid gland: US screening in middle-aged women with no previous thyroid disease. Radiology. Nov 1989;173(2):507-10.
Cannon CR. Evaluation of the thyroid nodule. Am Fam Physician. May 1986;33(5):147-52.
AACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. Jan-Feb 2006;12(1):63-102.
Cohen JI, Salter KD. Thyroid disorders: evaluation and management of thyroid nodules. Oral Maxillofac Surg Clin North Am. Aug 2008;20(3):431-43. [Medline].
Eszlinger M, Krohn K, Hauptmann S, Dralle H, Giordano TJ, Paschke R. Perspectives for improved and more accurate classification of thyroid epithelial tumors. J Clin Endocrinol Metab. Jul 1 2008;[Medline].
Stang MT, Carty SE. Recent developments in predicting thyroid malignancy. Curr Opin Oncol. Jan 2009;21(1):11-7. [Medline].
Cortázar García R, Quirós López R, Acebal Blanco MM. [The role of radiologists in the management of thyroid nodules.]. Radiologia. Nov-Dec 2008;50(6):471-81. [Medline].
Weber T, Schilling T, Büchler MW. Thyroid carcinoma. Curr Opin Oncol. Jan 2006;18(1):30-5.
Brauckhoff M, Lorenz K, Ukkat J, et al. Medullary thyroid carcinoma. Scand J Surg. 2004;93(4):249-60.
Untch BR, Olson JA. Anaplastic thyroid carcinoma, thyroid lymphoma, and metastasis to thyroid. Surg Oncol Clin N Am. Jul 2006;15(3):661-79, x.
Papini E, Guglielmi R, Bianchini A. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. May 2002;87(5):1941-6. [Full Text].
Simeone JF, Daniels GH, Mueller PR. High-resolution real-time sonography of the thyroid. Radiology. Nov 1982;145(2):431-5.
Roman S, Mehta P, Sosa JA. Medullary thyroid cancer: early detection and novel treatments. Curr Opin Oncol. Jan 2009;21(1):5-10. [Medline].
Barroeta JE, Wang H, Shiina N. Is fine-needle aspiration (FNA) of multiple thyroid nodules justified?. Endocr Pathol. 2006;17(1):61-5.
Rosen JE, Stone MD. Contemporary diagnostic approach to the thyroid nodule. J Surg Oncol. Dec 15 2006;94(8):649-61.
Bartolotta TV, Midiri M, Runza G, et al. Incidentally discovered thyroid nodules: incidence, and greyscale and colour Doppler pattern in an adult population screened by real-time compound spatial sonography. Radiol Med (Torino). Oct 2006;111(7):989-98.
Tsantis S, Dimitropoulos N, Cavouras D, Nikiforidis G. Morphological and wavelet features towards sonographic thyroid nodules evaluation. Comput Med Imaging Graph. Dec 24 2008;[Medline].
Kim SM, Choi Y, Choi SI. Diagnostic Accuracy of Ultrasound Features in Thyroid Microcarcinomas. Endocr J. Jul 9 2008;[Medline].
Perlmutter GS, Goldberg BB, Charkes ND. Ultrasound evaluation of the thyroid. Semin Nucl Med. Oct 1975;5(4):299-305.
de los Santos ET, Keyhani-Rofagha S, Cunningham JJ, et al. Cystic thyroid nodules. The dilemma of malignant lesions. Arch Intern Med. Jul 1990;150(7):1422-7. [Medline].
Robbins RJ, Larson SM. The value of positron emission tomography (PET) in the management of patients with thyroid cancer. Best Pract Res Clin Endocrinol Metab. Dec 2008;22(6):1047-59. [Medline].
Goletti O, Monzani F, Caraccio N, et al. Percutaneous ethanol injection treatment of autonomously functioning single thyroid nodules: optimization of treatment and short term outcome. World J Surg. Jul-Aug 1992;16(4):784-9; discussion 789-90.
Livraghi T, Paracchi A, Ferrari C, et al. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Work in progress. Radiology. Jun 1990;175(3):827-9.
Paracchi A, Ferrari C, Livraghi T. Percutaneous intranodular ethanol injection: a new treatment for autonomous thyroid adenoma. J Endocrinol Invest. May 1992;15(5):353-62.
Baek JH, Jeong HJ, Kim YS, Kwak MS, Lee D. Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid. Jun 2008;18(6):675-6. [Medline].
Ahuja AT, Metreweli C. Ultrasound of thyroid nodules. Ultrasound Q. 2000;16(3):111-22.
Danese D, Centanni M, Farsetti A, et al. Diagnosis of thyroid carcinoma. J Exp Clin Cancer Res. Sep 1997;16(3):337-47.
Dworkin HJ, Meier DA, Kaplan M. Advances in the management of patients with thyroid disease. Semin Nucl Med. Jul 1995;25(3):205-20. [Medline].
Freitas JE, Freitas AE. Thyroid and parathyroid imaging. Semin Nucl Med. Jul 1994;24(3):234-45. [Medline].
Gharib H. Current evaluation of thyroid nodules. Trends Endocrinol Metab. 1994;5:365-9.
Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proc. Jan 1994;69(1):44-9. [Medline].
Goletti O, Monzani F, Lenziardi M, et al. Cold thyroid nodules: a new application of percutaneous ethanol injection treatment. J Clin Ultrasound. Mar-Apr 1994;22(3):175-8. [Medline].
Gooding GA. Sonography of the thyroid and parathyroid. Radiol Clin North Am. Sep 1993;31(5):967-89. [Medline].
Higgins CB, Auffermann W. MR imaging of thyroid and parathyroid glands: a review of current status. AJR Am J Roentgenol. Dec 1988;151(6):1095-106. [Medline].
Hodak SP, Burman KD. The calcitonin conundrum—is it time for routine measurement of serum calcitonin in patients with thyroid nodules?. J Clin Endocrinol Metab. Feb 2004;89(2):511-4. [Medline].
Hopkins CR, Reading CC. Thyroid and parathyroid imaging. Semin Ultrasound CT MR. Aug 1995;16(4):279-95. [Medline].
Imanishi Y, Ehara N, Mori J, et al. Measurement of thyroid iodine by CT. J Comput Assist Tomogr. Mar-Apr 1991;15(2):287-90. [Medline].
Kerr L. High resolution ultrasound: value of color Doppler. Ultrasound Q. 1994;12:21-43.
Kim EK, Park CS, Chung WY. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. Mar 2002;178(3):687-91. [Full Text].
Lumachi F, Borsato S, Tregnaghi A, et al. Accuracy of fine-needle aspiration cytology and frozen-section examination in patients with thyroid cancer. Biomed Pharmacother. Jan 2004;58(1):56-60. [Medline].
Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. Feb 25 1993;328(8):553-9. [Medline].
Price DC. Radioisotopic evaluation of the thyroid and the parathyroids. Radiol Clin North Am. Sep 1993;31(5):991-1015. [Medline].
Reading CC, Gorman CA. Thyroid imaging techniques. Clin Lab Med. Sep 1993;13(3):711-24. [Medline].

[ CLOSE WINDOW ]

Keywords

thyroid nodules, thyroid mass, thyroid tumor, thyroid cancer, thyroid carcinoma, thyroid cyst, focal chronic thyroiditis, thyroid abscesses, thyroid adenoma, papillary carcinoma, follicular carcinoma, medullary carcinoma, anaplastic thyroid carcinomas, thyroid lymphoma

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP, Chairman of Medical Imaging, Professor of Radiology, NGHA, King Fahad National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP is a member of the following medical societies: American Institute of Ultrasound in Medicine, Radiological Society of North America, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Yousif Al-Khattab, MBChB, DMRD, FRCR, Consulting Staff, Department of Radiology, North Manchester Healthcare Trust, UK
Disclosure: Nothing to disclose.

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Hussein M Abdel-Dayem, MD, Chief, Nuclear Medicine Service, Department of Radiology, Professor of Radiology, St Vincent's Catholic Medical Centers of New York
Disclosure: none None None

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

C Douglas Phillips, MD, Professor, Departments of Radiology, Neurosurgery, and Otolaryngology, University of Virginia Health Sciences Center
C Douglas Phillips, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Society of Head and Neck Radiology, American Society of Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Amirsys Royalty Consulting

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

Search for CME/CE on This Topic »

CLOSE [X]
SPECIALTY SITES Allergy & Clinical Immunology Anesthesiology Cardiology Critical Care Dermatology Diabetes & Endocrinology Emergency Medicine Family Medicine Gastroenterology General Surgery Hematology-Oncology HIV/AIDS Infectious Diseases	Internal Medicine Lab Medicine Nephrology Neurology Ob/Gyn & Women's Health Oncology Ophthalmology Orthopaedics Pathology & Lab Medicine Pediatrics Plastic Surgery & Aesthetic Medicine Psychiatry & Mental Health Public Health & Prevention Pulmonary Medicine	Radiology Rheumatology Surgery Transplantation Urology Women's Health OTHER SITES Business of Medicine Medscape Today Med Students Nurses Pharmacists

eMedicine Specialties > Radiology > Head/Neck

Thyroid Nodules: Multimedia

Multimedia

Coned apical radiograph of the upper thorax shows curvilinear calcification in a thyroid adenoma, at the root of the neck, on the right side.

Posteroanterior chest radiograph shows a large retrosternal goiter (G) that displaces the trachea to the left (arrow).

Plain anteroposterior radiograph of the neck shows punctate calcification to the right of the cervical spine (straight arrow) and further multiple conglomerates of calcification at the root of the neck (curved arrow), also on the right.

Standard posteroanterior chest radiograph (in the same patient as in Image 3) shows widening of the superior mediastinum on the right in a lobulated fashion.

Posteroanterior chest radiograph shows a large, lytic, expanding metastasis in the anterior aspects of the right fifth and sixth ribs, secondary to an anaplastic thyroid carcinoma in an 85-year-old woman. Note displacement of the trachea to the left by a mass lesion at the root of the neck.

Anteroposterior chest radiograph of an 86-year-old woman who had been unwell for a few months and was losing weight. The radiograph shows a right superior mediastinal mass.

Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass (m) at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (same patient as in Image 7).

Ten-millimeter computed tomography section through the thorax shows a heterogeneous mass (m) at the root of the neck, on the left, that displaces the trachea to the right. The mass appears to be growing in the caudal direction and is reaching the arch of the aorta (same patient as in Images 7-8).

Computed tomography scan shows a mass in the posterior mediastinum (P), which displaces the air-filled esophagus to the right (arrow) (same patient as in Images 7-10).

Iodine-123 thyroid scan shows that a mass is a multinodular goiter (G). The posterior mediastinal mass is a hiatus hernia (H); the stomach (S) is shown. Further investigation revealed that thyrotoxicosis was the cause of the patient's symptoms (same patient as in Images 7-11).

Technetium-99m pertechnetate thyroid scan demonstrates normal findings in a thyroid gland.

Technetium-99m pertechnetate thyroid scan demonstrates an autonomous nodule with increased activity. Uptake in the remainder of the thyroid is suppressed.

Technetium-99m pertechnetate thyroid scan demonstrates intense activity in a large thyroid gland in a patient who was hypothyroid. The patient had Pendred syndrome. Note the pyramidal lobe (P).

Technetium-99m pertechnetate thyroid scan demonstrates a thyrotoxic goiter. Note the pyramidal lobe (arrow).

Technetium-99m pertechnetate thyroid scan demonstrates a multinodular goiter.

Technetium-99m pertechnetate thyroid scan demonstrates a cold nodule in the left lobe of the thyroid (C).

Technetium-99m pertechnetate thyroid scan shows a photon-deficient mass in the upper pole of the left lobe in a 53-year-old woman with a sudden onset of pain in the anterior aspect of the neck.

Sonogram demonstrates a multilocular benign cyst (same patient as in Image 19).

Repeat 3-month follow-up sonogram in a 53-year-old woman with a sudden onset of pain in the anterior part of the neck shows that the septa have resolved. However, debris and strands are noted at the bottom of the cyst (same patient as in Images 19-20).

Sonogram demonstrates a cystic colloid cyst with a comet tail artifact, in the thyroid.

Sonogram demonstrates a benign cystic lesion in the thyroid, with a surrounding halo and ragged walls.

Sonogram demonstrates a multilocular benign cyst in the thyroid.

Sonogram demonstrates thyroid cystic lesions in a 13-year-old female adolescent with cystic papillary thyroid carcinoma.

Technetium-99m pertechnetate thyroid scan shows a large cold nodule in the left lobe of the thyroid and a further, smaller cold nodule in right lobe.

Sonogram shows a 4-cm, hypoechoic, left-lobe thyroid mass (in the same patient as in Image 27).

Sonogram displaying a palpable, asymptomatic thyroid nodule (same patient as in Images 27-28) shows a solid mass in the thyroid, with a completely surrounding halo. The final diagnosis was a follicular carcinoma of the left lobe and a benign adenoma of the right lobe.

Image in a patient with a palpable, asymptomatic thyroid nodule shows a solid mass in the left lobe, with a complete surrounding halo (thyroid adenoma).

Power Doppler sonogram shows peripheral vascularity but no detectable flow in the tumor. The final diagnosis was benign thyroid adenoma (same patient as in Image 30).

A 56-year-old man underwent subtotal thyroidectomy for a familial medullary carcinoma 2 years previously. On routine follow-up examination, a mass was felt in the thyroid. Coronal, T1-weighted magnetic resonance imaging scan shows a carcinoma recurrence (R) and lymph node (L) metastases.

More on Thyroid Nodules

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Coauthor(s)

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor