What is a colloid goitre?
Prof of Medicine and Head of Endocrinology,
Maulana Azad Medical College,
New Delhi
Q: I am 24 years old. I have a small growth on the right side of the thyroid gland area which was noticed by an ENT specialist. We have done the thyroid tests and the results are - T3: 1.2 ng/ml; T4: 10.3 ug/dl; TSH: 0.8 U/ml; Free T3: 5.1 pg/ml and Free T4: 1.3 ng/ml. We had also gone for an ultrasound thyroid scan and FNAC, which confirmed the existence of nodules. The details are - Right lobe of Thyroid 2x1.2 cm with hypoechoeic S.O.L of size 1.6x0.7 cm seen over right lobe of thyroid adjacent to right C.C.A. Left lobe of Thyroid - 1.6x1.0 cm with normal parenchymal echogenecity. No evidence of S.O.L seen. All vessels appear normal. Isthmus - 4 cm. Impression: Hypoechoeic S.O.L right lobe of Thyroid. ? Nodules; ? Cysts. FNAC - solitary thyroid nodule in right lobe. Examination carried out: FNAC from thyroid nodule. Microscopic observation: malignant cells were not found; inflammatory cells were not seen; smears showed few sheets of benign cuboidal follicular cells on eosinophilic homogenous colloid material. Impression: smears were that of colloid goitre. What is your expert opinion on this? Should I worry about the nodules? Is there any chance of it being cancerous even though the FNAC has confirmed that they are not? Whom should we consult further? What is a colloid goitre? Is it because of a hormonal problem?
A:Colloid goitre is a common condition world wide. A recent study has shown that, on ultrasound, 4% US population has goitre. Some populations such as living in subhimalayan region has very high prevalence. But situation is changing now with the Universal Iodization Programme.The most common cause of this problem is Iodine deficiency sometime in life. Implications are not grave as most of the people with colloid goitre have no symptoms and thyroid functions (TSH, T3 and T4 are normal. Chances of malignancy are very very less. Only thing required is periodic examination of size of gland by Ultrasound (once in 2-3 years) and TSH levels once in a year. So please do not worry about these benign nodules in your thyroid gland.