Thyroid cysts contain fluid and vary in size. They may be small (less than 1 cm) or quite large. They may develop slowly or arise rapidly. Many thyroid nodules are not entirely cystic, buth has some solid components. Cystic nodules may expand and enlarge suddenly sometimes due to hemorrhage or bleeding within a smaller pre-existing nodule.
Cysts that are entirely fluid filled have a much lower risk of harboring a small thyroid cancer compared to cysts that have solid components. Diagnosis of a cystic thyroid lesion may be made at the time of ultrasound, or following a thyroid aspiration biopsy, when fluid is obtained from the thyroid lesion. Complete spontaneous resolution of a thyroid cyst may occur, but is uncommon (~ 15 % of cases).
Most large cysts or complex cysts should be aspirated with a fine needle to rule out the possibility of malignancy.
Causes of Hemorrhage Into Thyroid Cyst
Most thyroid nodules are benign growths caused by cycles of hyperplasia (increaed cellular activity) and involution of underlying thyroid tissue. This process results in the fusion of regions of colloid-filled follicles and parenchyma, forming what is called adenomatous or colloid nodules. Although the thyroid is the most common endocrine organ to undergo malignant degeneration, thyroid carcinoma accounts for only 1% of diagnosed neoplasms in the United States each year. Thyroid cancer is rare. Inflammatory nodules represented by focal chronic thyroiditis and thyroid abscesses are usually symptomatic, but they are rare.
Thyroid cysts account for 15-25% of all thyroid nodules. True thyroid cysts lined with epithelium are rare. Most thyroid cysts are macronodules, which undergo degeneration, with the accumulation of serous fluid, colloid substance, or blood.
Signs and Symptoms of Hemorrhage Into Thyroid Cyst
Hemorrhage into a thyroid cyst may produce a rapidly enlarging cyst and corresponding symptoms in the neck. These symptoms may include pain, trouble swallowing, and rarely, compression of vocal cords leading to a change in voice quality. Very large cysts can occasionally lead to obstruction of the airway and difficulty with breathing. Shortness of breath, rapid heart rate and anxiety will occur.
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Medical Content Last Updated on 07/12/2008
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