Hurley D L, Gharib H
Mayo Medical School, Rochester, MN, USA.
Geriatrics. 1995 Jun;50(6):24-6, 29-31.
The thyroid gland is known to become more nodular with age. The clinical questions in a given patient are whether the nodule(s) is benign or malignant and euthyroid or toxic. Toxic multinodular goiter (MNG) is more common in the elderly than Graves' disease but is not associated with the classic eye or skin findings. Drug therapy is usually effective, but total thyroidectomy may be preferred. Nontoxic MNG is common among older women. Treatment remains controversial because of potential side effects of suppressive therapy. Although thyroid carcinoma is rare, most of the more aggressive tumors are seen after age 50. Fine-needle aspiration and cytologic examination are useful in separating benign from malignant tumors.
甲状腺会随着年龄增长而出现更多结节。对于特定患者的临床问题是，这些结节是良性还是恶性，以及甲状腺功能正常还是亢进。毒性多结节性甲状腺肿（MNG）在老年人中比格雷夫斯病更常见，但与典型的眼部或皮肤表现无关。药物治疗通常有效，但全甲状腺切除术可能更受青睐。非毒性MNG在老年女性中很常见。由于抑制治疗存在潜在副作用，治疗仍存在争议。尽管甲状腺癌很少见，但大多数侵袭性较强的肿瘤在50岁以后出现。细针穿刺和细胞学检查有助于区分良性肿瘤和恶性肿瘤。
