It can be divided into benign and malignant categories. The etiology is unknown, and the pathological changes are thyroid follicular hyperplasia and thyroid tissue enlargement. Benign texture is soft, while malignant texture is hard. Benign: Most of the cervical masses are single and grow slowly, and there may be compression symptoms when they are large. The lump moves up and down with swallowing, smooth, soft, round or oval, which may cause hyperthyroidism. When the tumor is small, it can be reduced and disappeared by irradiation with general therapeutic equipment; When the tumor is too large, it should be irradiated after surgical resection, which can achieve the purposes of diminishing inflammation, relieving pain, reducing swelling, accelerating wound healing and preventing infection and scar.
One tenth of thyroid benign tumors can develop into malignancy, and malignancy may also be related to radiation exposure. Malignant thyroid tumors are divided into papillary adenocarcinoma, follicular adenocarcinoma, undifferentiated carcinoma, medullary carcinoma, squamous cell carcinoma and lymphoma. There is a lump in the neck of thyroid gland or its adjacent parts, and the texture is hard and uneven. There are no obvious symptoms in the early stage, but hoarseness, dyspnea or dysphagia, occipital and shoulder pain or diarrhea, palpitation, facial flushing and hypocalcemia may occur in the late stage. Anyone who is diagnosed as malignant thyroid cancer should undergo surgical resection or radioactive iodine therapy and chemotherapy according to the pathological type, and can be treated with a general therapeutic instrument. Thyroid patients should use QK- S15 general therapeutic table besides QK-General therapeutic apparatus for radiotherapy, and the effect is better.
Irradiation sites: front of neck, back of neck, chest, back, abdomen, waist, etc.
Thyroid adenoma is a chronic lesion of the neck, confined to the front of the neck, shaped like a walnut, hard in texture, and can move up and down with swallowing. The main cause of the disease is due to long-term anger or depression, stagnation of liver qi, and then stagnation and stagnation of body fluid and qi and blood, which accumulate into phlegm for a long time, and qi stagnation and phlegm and gas converge in front of the neck. Secondly, it is also related to soil and water, diet, physical fitness and other factors. Generally, there are no obvious symptoms at the initial stage of the disease, which is often found by B-ultrasound during physical examination. After the discovery, most patients take surgical treatment or no treatment. It is easy to relapse after surgical treatment, and the recurrence rate is as high as 90%, which is difficult to cure. If left untreated (because there are no obvious symptoms: no pain, no itching), the course of disease will become refractory or worsen into thyroid cancer. According to relevant data, the canceration rate of thyroid adenoma is as high as 10%-20%. Thyroid adenoma is quite common, often occurring under 40 years old, especially in women aged 20-40.
& ltI >, pathological classification
1. Follicular adenoma: It is the most common benign thyroid tumor, which can be divided into:
& lt 1 & gt； Embryonic adenoma.
& lt2> Fetal adenoma.
& lt3> Glioma, also known as follicular adenoma (the most common).
& lt4> Simple adenoma
& lt5> Eosinophilic adenoma
2, papillary adenoma: benign papillary adenoma is rare, mostly cystic, so it is also called papillary cystadenosis. Among thyroid adenoma, adenoma with papillary structure has a greater malignant tendency.
3. Atypical adenoma: relatively rare, with intact capsule and solid texture.
4. Thyroid cyst: According to different contents, it can be divided into glial cyst, serous cyst, necrotic cyst and hemorrhagic cyst.
5. Functionally autonomous thyroid adenoma: old hemorrhage, necrosis, cystic degeneration, vitreous degeneration, fibrosis and calcification can be seen in the tumor parenchyma area. The boundary of tumor tissue is clear, and the surrounding thyroid tissue often shrinks.
< second > clinical manifestations:
1. Most benign thyroid tumors are single thyroid nodules, and a few are multiple thyroid nodules, except for functionally autonomous thyroid tumors. The course of the disease is slow and asymptomatic. Most people find neck lumps within several months to several years or even longer, because they are slightly unwell or the lumps reach 1cm or even larger, or they have no symptoms. When doing B-ultrasound in routine physical examination, I found a neck lump. Most of them are single, round or oval, with smooth surface, clear boundary, solid texture, no adhesion with surrounding tissues and no tenderness, and can move up and down with swallowing. Tumors are usually a few centimeters, and giant tumors are rare. Giant tumors can cause compression of adjacent organs, but they do not infringe on these organs, such as compressing trachea and displacing organs. In a few cases, the tumor suddenly expanded, local swelling and pain, due to bleeding within the tumor.
2. Functionally autonomous thyroid adenoma is more common in women. Patients often have a long history of thyroid nodules. Initially asymptomatic or only mild palpitation, emaciation and fatigue. With the development of the disease, patients have different degrees of thyroid poisoning symptoms, most of them have hyperthyroidism symptoms, and some may have hyperthyroidism crisis.
3. Some thyroid adenomas can become cancerous, and the canceration rate is 10-20%. In the following cases, the possibility of canceration should be considered:
& lt 1 & gt； Recently, the tumor has increased rapidly;
& lt2> Tumor activity is limited or fixed;
& lt3> has symptoms of oppression such as hoarseness and dyspnea;
& lt4> The tumor is hard and has a rough surface.
& lt5> Cervical lymph node enlargement.
< third >, laboratory and other inspections:
1. Ultrasound examination of thyroid gland: B-ultrasound can clearly distinguish whether thyroid mass is cystic or parenchymal, and color B-ultrasound can also observe the blood flow of the mass, providing reference for the diagnosis of benign and malignant tumors. Blood-rich may become malignant.
2. Determination of thyroid uptake rate 13 1: No matter benign or malignant tumor, thyroid uptake rate 13 1 is normal, and functional autonomous thyroid adenoma can be higher.
3. Thyroid radionuclide scanning: thyroid adenoma and a few thyroid cancers can show hot nodules or warm nodules, while thyroid cysts, cystic changes of thyroid adenoma or internal bleeding show cold nodules or cold nodules with clear outline and regular boundaries.
4. Thyroid function is normal.
5. X-ray examination of the neck: When the thyroid tumor is huge, the trachea can be compressed or displaced, and calcification images can be seen in some tumors. Thyroid lymphography showed that there was a circular filling defect in the reticular structure, with regular edges and complete development of surrounding lymph nodes.
& lt fourth > etiology and pathogenesis
Traditional Chinese medicine believes that the occurrence of this disease is closely related to poor emotion, unsuitable living, lack of healthy qi and lack of suppression of evil.
1, emotional disorder: sadness, thinking, depression, anger, leading to liver depression and qi stagnation, liver failure, liver wood with soil, spleen unhealthy, phlegm and dampness staying in the body; Or liver depression turns into fire, and body fluid burns into phlegm. Turbid qi and phlegm-dampness condense in the neck; Liver depression and qi stagnation, disharmony between qi and blood meridians, qi stagnation and blood stasis, obstruction of meridians, and tumor formation on the neck.
2, not suitable for living: living in mountainous areas and plateau areas for a long time, the water quality is too biased. Over time, the qi machine runs abnormally, the water is wet and stops, and phlegm and blood stasis are intertwined, forming tumors.
3. Deficiency of vital qi and stagnation of pathogenic qi: the vital qi is weak, and the pathogenic toxin enters from deficiency, blocking the blood stasis in the meridians before the neck; Congenital deficiency, physical weakness, pathogenic toxin and physical weakness, and pathogenic fire stagnation in the neck.
In short, the occurrence of this disease is closely related to the liver and spleen. Under the action of many factors, qi and blood are coagulated by phlegm, resulting in qi stagnation and blood stasis and phlegm coagulation, which will become a tangible lump after a long time.
Thyroid tumors can be divided into benign tumors and malignant tumors. Clinically, thyroid tumors often only show thyroid nodules, so thyroid tumors and thyroid nodules are often mixed. In fact, nodules are only morphological descriptions, including tumors, cysts, masses of normal tissues and thyroid masses caused by other diseases. It is difficult to determine the nature of thyroid nodules in clinic. Even pathological biopsy sometimes makes it difficult to distinguish thyroid adenoma from nodular hyperplasia, benign tumor from malignant tumor. Therefore. It is difficult to accurately count the incidence of thyroid tumors.
Thyroid tumor is a common disease, and the incidence varies greatly in different regions. The incidence of thyroid tumors in endemic areas of goiter is higher than that in non-endemic areas. Among thyroid tumors, benign thyroid tumors are the most common. Thyroid cancer is not common, but it has been increasing year by year in recent years. Surgery confirmed that 80% of patients with solitary nodules were benign and 20% were malignant. The incidence of single nodule is 15.6%-28.7%, while the incidence of multiple nodular carcinoma is generally less than 10%, indicating that the possibility of single nodular carcinoma is several times higher than that of multiple nodules. From the perspective of gender, thyroid tumors are more common in women, and the incidence rate is four times higher than that of men. However, from the perspective of the ratio of thyroid cancer to thyroid nodules, men are higher than women at all ages. The incidence of benign and malignant thyroid masses is similar, but the incidence of thyroid cancer in childhood thyroid nodules is relatively high, accounting for about 50%-7 1%. Therefore, we should pay special attention to the possibility of canceration of thyroid nodules in children.
Etiology and introduction:
Thyroid adenoma is the most common benign thyroid tumor. Pathologically, it can be divided into follicular (common) and papillary (rare) cystic adenoma, with yellowish or crimson section and intact capsule. It can be secondary to hyperthyroidism (about 20%) and malignant transformation (about 10%).
Clinical manifestations:
More common in women under the age of 40. Patients often have no discomfort, and lumps are often found unintentionally. Generally, it is a single nodule, mostly located near the isthmus of thyroid gland. Hard, smooth, tender, oval or spherical, with clear edges, it moves up and down with swallowing and grows slowly. However, after malignant transformation, cystic transformation and bleeding, the tumor can grow rapidly.
General treatment and prevention:
In principle, early surgical resection should be performed. Generally, subtotal thyroidectomy is performed on the affected side, including adenoma; If the tumor is small or cystic, it can also be completely removed together with some normal thyroid tissues around it. Recently, it is advocated to remove the isthmus of Yequan and the contralateral lobe 1/3 to prevent the possibility of tumor multicentric lesions. Shuang Ye multiple adenoma, Shuang Ye thyroidectomy.
Benign thyroid tumors generally have a good prognosis and a low recurrence rate.
After subtotal thyroidectomy, there is generally no effect on physiology.
Overview of thyroid tumors
Follicular tumor is the most common thyroid tumor, the first is goiter, adenoma is generally round or oval, with a diameter less than 3cm, single or multiple. The texture is tougher than the surrounding thyroid tissue, with no tenderness and slow growth. At first, the nodule has the function of concentrating iodine, but it is a warm nodule after scanning, and the amount of thyroid hormone released by the nodule is not much. With the enlargement of nodules, the function is improved, and the released thyroid hormone is increased, which can cause hyperthyroidism in clinic. Radioimmunoassay is T3 type, and thyroid scan is "hot nodule". The thyroid tissue outside the nodule atrophies and loses iodine function, which is often underdeveloped. This is often referred to as a highly functional or toxic adenoma.
Neixiao scrofula pill is used to treat chronic lymphadenitis, lymphadenitis, hyperplasia of mammary glands and benign breast masses.
Drug Name Generic Name: Neixiao Pianli Pill
Chinese Pinyin: Neixiao Luo Li Pill
Ingredients: Spica Prunellae, Scrophularia, seaweed, Fritillaria thunbergii, Trichosanthis Radix, Fructus Forsythiae, Radix et Rhizoma Rhei preparata, Radix Ampelopsis, Fructus Aurantii, Natrii Sulfas, etc.
This product is a grayish yellow water pill; The gas is slightly fragrant, and the taste is salty and bitter.
Indications: softening and resolving hard mass. Swelling or pain of sputum nucleus with globular lymph node nucleus.
Usage, Dosage, Usage and Dosage This product is a paste pill, bottled with 9 grams per bottle100g, three times a day, and taken with warm water.
Characteristics This product is a brown to brownish concentrated pill; The gas is slightly fragrant, salty and bitter.
Indications: softening and resolving hard mass. Used for scrofula, phlegm, swelling or pain.
Administration and dosage Take orally, 8 capsules at a time, 3 times a day.
Pregnant women are forbidden.
Caution: People with loose stools should use it with caution.