Department of Endocrinology, University of Pisa, Pisa, Italy.
Best Pract Res Clin Endocrinol Metab. 2010 Feb;24(1):51-61. doi: 10.1016/j.beem.2009.08.008.
Nodular goitres are enlargements of the thyroid gland. In the absence of thyroid dysfunction, autoimmune thyroid disease, thyroiditis and thyroid malignancy, they constitute an entity described as non-toxic nodular goitre, which occurs both endemically and sporadically. In the early phase of goitrogenesis, goitres are diffuse and, with time, such goitres tend to become nodular. Concomitantly, thyroid function often becomes autonomous, and therefore the patients gradually develop hyperthyroidism. Some non-toxic goitre patients have no symptoms at all, or just complaints of cosmetic disfigurement. In the diagnostic evaluation protocol, neck palpation and several imaging methods are available: ultrasonography (US), the new developed US elastography, scintigraphy, computed tomography (CT) scan and magnetic resonance imaging (MRI). Fine-needle aspiration biopsy (FNAB) provides the most direct and specific information about a thyroid nodule. Recently, a combination of cytology and molecular testing has shown significant improvement in the diagnostic accuracy and allowed for better prediction of malignancy in thyroid nodular disease.
结节性甲状腺肿是甲状腺的肿大。在不存在甲状腺功能障碍、自身免疫性甲状腺疾病、甲状腺炎和甲状腺恶性肿瘤的情况下，它们构成了一种被描述为非毒性结节性甲状腺肿的实体，这种疾病既可以是地方性的，也可以是散发性的。在致甲状腺肿物质生成的早期，甲状腺肿是弥漫性的，随着时间的推移，这种甲状腺肿往往会变成结节性的。同时，甲状腺功能常常变得自主，因此患者逐渐发展为甲状腺功能亢进。一些非毒性甲状腺肿患者根本没有任何症状，或者只是抱怨美容缺陷。在诊断评估方案中，可采用颈部触诊和几种影像学方法：超声（US）、新开发的 US 弹性成像、闪烁扫描、计算机断层扫描（CT）和磁共振成像（MRI）。细针穿刺活检（FNAB）为甲状腺结节提供了最直接和最特异的信息。最近，细胞学和分子检测的联合应用显示出在诊断准确性方面的显著提高，并允许更好地预测甲状腺结节性疾病的恶性程度。
