What do diffuse changes in the thyroid gland indicate? Diffuse changes in the parenchyma of the thyroid gland is What does it mean diffuse changes in the parenchyma of the thyroid gland

Diffuse changes in the thyroid gland are changes in the tissues of the entire thyroid gland, which is detected during an ultrasound examination (ultrasound).

With certain transformations in the gland, using ultrasound diagnostics, a change in the ability of the thyroid tissue to reflect sound (called echogenicity) is ascertained. In this case, we can say that the entire gland reflects ultrasonic waves in a different way than a healthy organ should do. In the future, a more accurate diagnosis is required, which will reflect the true state of the thyroid gland. Therefore, "diffuse changes in the thyroid gland" is just a term that is used in the method of ultrasound diagnostics and can mean diseases of the gland that are different in nature.

ICD-10 code

E00-E07 Diseases of the thyroid gland

Causes of diffuse changes in the thyroid gland

The causes of diffuse changes in the thyroid gland are as follows:

Insufficient amount of iodine in the body.

If a person lives in an area where the soil and water are poor in iodine, then this greatly affects the appearance of diffuse changes in the thyroid gland. These regions in medical practice are called endemic, that is, those where a certain disease has a mass distribution. Therefore, we can say that thyroid diseases in such areas are common.

Changes in the hormonal balance of the thyroid gland.

Violation of the reproduction of thyroid hormones (more or less of them than the body needs) affects the appearance of the gland and the structure of its tissue. In this case, an increase in the organ may occur, which occurs evenly and in all directions, which is called a diffuse enlargement of the thyroid gland.

Autoimmune disorders, expressed in inflammation of the tissues of the thyroid gland.

Usually, inflammatory processes in this organ are of an autoimmune nature. That is, inflammatory disorders in the thyroid gland occur due to the fact that the human immunity, due to a number of pathological reasons, begins to become aggressive to the thyroid gland. This disease is called chronic autoimmune thyroiditis (or lymphomatous thyroiditis). The course of this disease is characterized by the formation of antibodies and lymphocytes in the body that damage the cells of one's own thyroid gland. It should be taken into account that in the normal state of the human immune system, the production of antibodies occurs in response to the penetration of foreign elements into the body.

Unbalanced nutrition.

With a lack of food rich in iodine, changes in the structure and functioning of the thyroid gland can be observed. The same anomalies occur if the patient's food contains large quantities of food products, which contain substances that prevent the production of thyroid hormones. These products include cabbage (white, cauliflower, Brussels sprouts), corn, beans, turnips, peanuts, soybeans.

A change in the ecological situation in the region, which occurred suddenly due to various factors.

For example, the tragedy of the Chernobyl nuclear power plant, which affected the sharp deterioration of the environment in the territories adjacent to this plant, caused general changes in the thyroid gland among the population.

Diffuse changes in the thyroid gland are a manifestation of the following diseases:

endemic goiter,
chronic autoimmune thyroiditis,
subacute thyroiditis,
mixed goiter,
diffuse toxic goiter.

Symptoms of diffuse changes in the thyroid gland

Symptoms of diffuse changes in the thyroid gland are manifested in the following factors:

The appearance of heterogeneity in the structure of the tissue and different density of the surface of the gland, which exclude the appearance of focal transformations in the thyroid gland.
Change in the volume of the thyroid gland, which is expressed in its increase. In some cases, the growth of thyroid tissue leads to the formation of a goiter - a strong pathological increase in the volume of the thyroid parenchyma.
The appearance of fuzziness, blurring of the external contours of this organ.
The resulting changes in the functioning of the thyroid gland, which are accompanied by a violation of the hormonal background. These changes are of two types:
- hyperthyroidism - manifested in an increase in the level of thyroid hormones;
- hypothyroidism - manifested in a decrease in the level of thyroid hormones.

Among the accompanying symptoms of diffuse enlargement of the thyroid gland, the following can be distinguished:

the appearance of dry hair;
brittle nails;
the presence of persistent colds;
the presence of constant chills;
the presence of constant lethargy, weakness and increased fatigue;
decrease in working capacity and labor productivity (physical and intellectual);
the appearance of an anxious and neurotic state, as well as increased irritability or depression;
decrease in intellectual abilities;
the emergence of problems with cognitive processes - memorization and reproduction of information, concentration of attention, general perseverance;
the appearance of changes in weight that are not related to the quantity and quality of nutrition of the patient;
the appearance of disorders in the functioning of the endocrine system, which cause hormonal imbalance in the body;
the occurrence of problems with the sexual sphere of a person, a decrease in the sexual functions of the body;
the presence of permanent, chronic constipation, not related to the diet of the patient.

Forms

Diffuse changes in the parenchyma

Parenchyma is a certain set of organ cells that carries a certain functional load. The parenchyma differs from the stroma in that it originates from different types of tissue. If the stroma is formed only by connective tissue cells, then the parenchyma may include hematopoietic tissue (for example, in the spleen), epithelial tissue (for example, various glands of the epithelium)), nerve cells (or nerve nodes) and so on.

The parenchyma and stroma are in close "collaboration" and they cannot be separated, since it is this integrity that allows the organ to work normally. The stroma is a kind of skeleton for the organ, the "skeleton", and the parenchyma fills each organ with a specific functional purpose.

The thyroid parenchyma is a functional epithelial tissue, which consists of actively dividing cells. The thyroid parenchyma consists of follicles, namely vesicles of various sizes, which are the units of the structure and functioning of this tissue. On average, each follicle is equal to forty to fifty micromicrons. Each of the bubbles is braided with blood vessels and capillaries of the lymphatic system. Thyroid follicles produce two hormones: triiodothyronine and tetraiodothyronine (or thyroxine). The triiodothyronine unit contains three iodine molecules, and the thyroxine unit contains four iodine molecules. Thyroid hormones are abbreviated as T3 and T4 respectively. The hormone T4, secreted by the gland, in the cells and tissues of the body is transformed into the hormone T3, which is the main substance that affects the metabolic processes of a person.

Diffuse changes in the parenchyma of the thyroid gland are changes in the entire tissue of the parenchyma that are associated with an increase in the thyroid gland. At the same time, it should be taken into account that the entire parenchyma of the gland underwent transformation, and these changes are distributed evenly over the entire area of the organ. Visually, this phenomenon can be observed as an increase in the volume of the thyroid gland in all directions.

Diffuse changes in the parenchyma of the thyroid gland are detected by palpation during examination by an endocrinologist. After undergoing an ultrasound scan, which is prescribed by a specialist, in some cases a diagnosis of "diffuse changes in the thyroid parenchyma" is established. Such a diagnosis can be made even in the absence of any other signs of thyroid disease. In these cases, the patient is still not bothered by anything, but the gland itself is already functioning in tension mode. Therefore, any additional negative stimuli - stress, emotional and physical overload, infectious diseases - can provoke the progression of the disease. In this case, the functioning of the thyroid gland is disturbed, which is manifested in the appearance of an imbalance in the production of hormones. The production of thyroid hormones can increase or decrease, which affects their amount in the blood of a person, which negatively affects the functioning of the whole body, and also leads to the appearance of many symptoms of a health disorder.

In some cases, such diffuse changes in the thyroid parenchyma are associated from the very beginning with a violation of the hormonal balance of the gland and lead to an external increase in the organ.

Diffuse structural changes

Diffuse changes in the structure of the thyroid gland are transformations that occur in the gland, which are associated with a change in the structure of the organ tissue.

With a diffuse increase in the thyroid gland, the structure of the gland changes: it becomes denser and increases in volume. In the early stages of diffuse enlargement of the thyroid gland, there are usually no symptoms of such changes. In this case, changes in the structure of the organ are ascertained when visiting an endocrinologist who examines and palpates the gland. After detecting abnormalities in the structure of the thyroid gland, the specialist prescribes a laboratory blood test in order to determine the hormonal status and the level of antibodies to the thyroid gland.

At different stages of diffuse enlargement of the thyroid gland, as well as with different diseases that caused it, the test results may be different. The initial stage of the disease may be accompanied by a normal hormonal status, that is, the absence of any disturbances in the reproduction of thyroid hormones. At the same time, in terms of laboratory tests, there is an adequate amount of thyroxine and triiodothyronine, which are produced by iron.

All of the above does not apply to autoimmune disorders, since even in the early stages of such diseases, an increased amount of antibodies in the blood serum is noted. This is because the patient's immunity has already begun to stimulate the human body to enhanced functioning against its own organ - the thyroid gland.

After laboratory tests (or together with them), an ultrasound examination (ultrasound) is prescribed to make a diagnosis and prescribe appropriate therapy.

The progression of thyroid disease leads not only to a change in the structure of gland tissues, but also to malfunctions of the whole organism. The very first “hit” is taken by the nervous system: a person becomes anxious and restless, as well as irritable and unbalanced. Then there are problems with the functioning of the heart and blood vessels, the activity of the reproductive system is disrupted. Metabolic processes in the body also suffer, since thyroid hormones regulate calcium metabolism in the body. As a result, the patient may develop multiple caries and osteoporosis.

Diffuse-focal changes

Diffuse-focal changes in the thyroid gland is an increase in thyroid tissue, in which the appearance of foci with an altered structure of the gland tissue is observed. Moreover, in most cases, these foci are surrounded by glandular tissue of the thyroid gland with an unchanged structure.

Neoplasms that are found on ultrasound can be different in structure and nature of the formation. These include:

cysts,
adenomas,
teratoma,
hemangiomas,
paragangliomas,
lipomas
cancerous tumors.

Diffuse-focal changes in the thyroid gland are not an independent disease, but appear as a result of a systemic imbalance in the body. Such anomalies are observed with the following diagnoses:

nodular goiter,
mixed goiter,
thyroid adenoma,
thyroid cancer.

The detection of diffuse-focal changes in the thyroid gland should alert the doctor and the patient, since this phenomenon may indicate the beginning of the development of benign or malignant tumor processes in the organ. Similar changes in the thyroid gland appear on ultrasound as foci with increased or decreased echogenicity. It is important to know that benign and malignant tumors have only their inherent indicator of echogenicity. Such a difference in the parameters of the examination allows us to make the diagnosis of ultrasound more accurate and competent.

Diffuse-nodular changes

Diffuse-nodular changes in the thyroid gland can be detected by palpation of the thyroid gland at an appointment with an endocrinologist. This can be done due to the fact that the location of the gland is superficial, and it is perfectly palpable.

Palpation of the organ is performed as follows. The patient is facing the specialist; while the patient can sit on a chair, stand or lie on the couch. By pressing on the gland in a certain way, the endocrinologist evaluates the size of the thyroid gland, the density of its tissue, as well as the uniformity of the structure of the organ. At this point, the doctor may detect areas with increased density and an increase in glandular tissue, which are called nodes. Also, a specialist can state diffuse changes in the thyroid gland, that is, a general increase in its volume. After such a preliminary examination, the endocrinologist prescribes an ultrasound scan for the patient.

An ultrasound specialist can confirm or refute a previously made preliminary diagnosis. Usually, the fears of endocrinologists during the examination are confirmed. If, during an ultrasound scan, a specialist detects nodes in the glandular tissue that are larger than one centimeter, this serves as the basis for a tissue biopsy of the suspicious node. The passage of such a procedure is prescribed by an endocrinologist after reviewing the results of ultrasound diagnostics. And only after a histological examination and laboratory blood tests for hormones, the attending physician establishes an accurate diagnosis and prescribes a course of drug treatment.

Usually, the nature of the occurrence of nodes is parenchymal, that is, it is associated with an increase in one or more follicles of the glandular tissue of the thyroid gland. Specialists call a thyroid nodule a neoplasm in the structure of the parenchyma, which has its own capsule, which limits the node from the healthy tissue of the organ.

For a long time, diffuse-nodular changes in the thyroid gland can be asymptomatic, and can be detected only at an appointment with an endocrinologist. If the thyroid nodes greatly increase in size, they begin to affect the functioning of the organs and tissues that are located nearby. For example, patients may complain of a feeling of suffocation, a change in the timbre of the voice, or the appearance of a feeling of a foreign lump in the throat. It is also common for large nodes to cause various changes in the structure and functioning of the larynx, which can cause pain symptoms.

For a large number of nodes, the process of degeneration of benign tissue into malignant is characteristic, which is called the process of malignancy. What is the nature of such a phenomenon, sometimes not known to the experts themselves. Therefore, patients who have diffuse-nodular changes in the thyroid gland should be under the constant supervision of endocrinologists.

Malignant neoplasms on ultrasound are characterized by reduced echogenicity, heterogeneity of the thyroid tissue structure and the presence of deposits of calcium salts in the neoplasm tissue.

Nodular changes in the thyroid gland are symptoms of the following diseases:

nodular colloid goiter,
fibrocystic adenoma,
carcinomas.

Diffuse cystic changes

Diffuse cystic changes in the thyroid gland is the presence of cystic formations in the glandular tissue of the thyroid gland against the background of a general increase in the volume of the organ.

Cystic neoplasms are cavitary in nature. Cysts have a capsule that limits them from normal thyroid tissue, and a cavity is always found inside the neoplasm. This cavity is filled with a colloid, that is, a liquid that contains a large amount of hormones produced by the gland.

Over a long period of time, diffuse cystic changes in the thyroid gland may not show any symptoms. And only at a preventive examination by an endocrinologist will there be a suspicion of the presence of cysts in the organ. The course of diseases such as a simple thyroid cyst and fibrocystic adenoma are accompanied by the formation of cysts in the organ.

Cysts are manifested not only in an increase in a certain area of \u200b\u200bthyroid tissue, which can give a feeling of the presence of a foreign element in the front of the neck. For such neoplasms, the appearance of suppuration from the ingress of a certain infection into the cyst is characteristic. In this case, the process of suppuration is accompanied by symptoms of an acute inflammatory process - an increase in body temperature, general intoxication of the body, the appearance of a sharp pain in the area of the cyst and nearby tissues.

For cysts, as for nodes, the process of degeneration of benign tissue into malignant is characteristic. Therefore, endocrinologists advise patients with a similar disease not to neglect the constant visits to specialists, and also strictly follow all prescribed methods of therapy.

Moderate diffuse changes

When undergoing an ultrasound examination of the thyroid gland, moderate diffuse changes in the thyroid gland can be detected. This means that the gland has some uniform enlargements over the entire surface, but they are not so large as to cause great concern. In this case, most often, the body functions in the correct mode, without disturbing the reproduction of hormones.

With moderate diffuse changes in the thyroid gland, there are no foci of tissue compaction or nodes. The entire parenchyma of the thyroid gland is enlarged to a small extent, but without changing the structure of the tissue.

In this case, the endocrinologist may consider that special treatment of the problem is not required. Such a decision can only be made when there are no other symptoms and disturbing manifestations of thyroid dysfunction for the doctor and patient.

At the same time, it must be remembered that the situation with an enlarged thyroid gland cannot be let out of control. Therefore, once or twice a year it is necessary to visit an endocrinologist, who will conduct an examination of the anterior zone of the neck, and also refer the patient to an ultrasound scan.

Pronounced diffuse changes

Pronounced diffuse changes in the thyroid gland are manifested in a strong increase in thyroid tissue, which is diagnosed as a result of an ultrasound examination.

Pronounced diffuse changes in the thyroid gland are characteristic of the following diseases of the organ:

autoimmune thyroiditis,
hyperthyroidism in Graves' disease (Graves' disease).

In some cases, pronounced diffuse changes in the thyroid gland are accompanied by a focal (nodular or cystic) increase in thyroid tissue.

As a rule, pronounced diffuse changes in the thyroid gland are associated with a violation of its functioning, which affects the hormonal balance in the patient's body. The gland begins to produce insufficiently or intensively certain thyroid hormones, which, in general, affects the general health and well-being of the patient. In addition to disturbing transformations in the gland, patients may complain of problems with the cardiovascular system, nervous system, reproductive organs, skeletal system, and so on. All such ailments are the result of improper functioning of the thyroid gland, the hormones of which affect the functioning of the whole organism.

Pronounced diffuse changes in the thyroid gland require mandatory drug treatment, which is prescribed by an endocrinologist after all the tests and examinations necessary in this case.

Diagnosis of diffuse changes in the thyroid gland

Diagnosis of diffuse changes in the thyroid gland can be carried out in several ways. The study of anomalies in the structure and functioning of the thyroid gland is carried out in the following order:

Examination by an endocrinologist.

When visiting this specialist, the patient's anterior cervical region is felt (palpated). If during this procedure some thickening of the thyroid gland is detected, alarming the doctor, the endocrinologist sends the patient for additional examination. Clarifying procedures will allow concretizing the diagnosis and choosing the most optimal solution to the problem in the form of appropriate treatment.

The use of imaging research methods, namely:
- ultrasound examination (ultrasound);
- computed tomography;
- magnetic resonance imaging (MRI).

Ultrasound diagnostics or ultrasound examination (ultrasound) is the most popular method for examining the thyroid gland. This method of obtaining information about the state of the thyroid gland compares favorably in that it is the safest diagnostic tool. Computed and magnetic resonance imaging are considered more potentially dangerous methods that affect the patient's health and, for these reasons, are used less frequently.

In the vast majority of cases, the diagnosis of "diffuse changes in the thyroid gland" is determined by the patient after the ultrasound procedure. Indications for such a study can be of several types:

complaints of the patient about his own state of health and well-being and / or sensations and external changes in the anterior cervical region;
suspicions that arose during the examination of the patient on the existing pathologies in the structure of the thyroid gland;
existing violations of the functioning of the thyroid gland, namely, a statement of hormonal imbalance in the patient's body, obtained as a result of laboratory studies (blood tests, and so on).

If there is no preliminary evidence in favor of pathological changes in the thyroid gland, ultrasound is not prescribed, since it is not a screening diagnostic method.

The diagnosis of "diffuse changes in the thyroid gland" is established if the results of ultrasound indicate a change in the echogenicity of the thyroid tissues. At the same time, heterogeneity of the echostructure of the organ can be detected - a decrease or increase in echogenicity in different parts of the gland, as well as a general decrease or increase in the echogenic qualities of the thyroid gland.

Computed or magnetic resonance imaging is good for detecting diffuse or focal lesions of thyroid tissue. The results of these studies are of great validity, since they can be used to qualitatively assess the structure and density of thyroid tissues.

Diagnosis of diffuse changes in the thyroid gland is, first of all, a statement of the fact of changes in the thyroid tissue. Clarifying diagnoses that allow you to determine the disease require additional research methods (for example, laboratory tests for hormones, and so on).

The thyroid gland is the largest endocrine gland in our body. It is located on the anterior surface of the trachea, slightly above the sternum. The organ consists of two halves, interconnected by a small isthmus. The main function of the thyroid gland is the production of hormones that control the basic metabolism in the body and the absorption of oxygen. Diseases of the gland lead to disruptions in the vital activity of the whole organism. The diagnosis of diffuse changes in the thyroid gland is usually made to the patient during an ultrasound examination of the organ, but this term itself is not a clinical diagnosis, but only one of the definitions of ultrasound of the thyroid gland.

Signs of diffuse changes in the thyroid gland

Diffuse organ damage means a change in the entire tissue of the thyroid gland, in contrast to focal (local) lesions. When diagnosed by ultrasound, clear signs of diffuse changes in the thyroid gland are a statement of an increase in the size of the organ and the heterogeneous echogenicity of its structure, that is, a deviation from the norm in the degree of tissue density. Also, sometimes diffuse changes are accompanied by the formation of nodes, in such conditions, if the size of the formation is more than one centimeter, the patient undergoes a biopsy of the node, to exclude suspicions of the malignant nature of the neoplasm.

In addition to abnormalities in the structure and tissues of the gland, with diffuse changes in the thyroid gland, a hormonal examination can reveal a decrease (hypothyroidism) or an increase (hyperthyroidism) in the level of thyroid hormone. In some cases, the inflammatory process of the organ can occur against the background of a level that is within the normal range.

Symptoms of the disease

Symptoms of diffuse-nodular changes in the thyroid gland can be:

Increased excitability, rapid mood swings;
Unreasonable change in weight;
Frequent acute respiratory infections;
Changes in the condition of the skin and subcutaneous tissue;
Changes in blood pressure;
Pain in the muscles;
Fast fatiguability.

When trying to treat the manifestations of symptoms, the patient's condition does not improve. It should be noted that in the initial stage of changes, symptoms are not observed, the gland only becomes denser and slightly increases in size. Violation is detected only during a scheduled dispensary examination by an endocrinologist. During palpation, a doctor can detect an increase and tuberosity of the organ, and then prescribe appropriate examinations and adequate treatment, since already existing diffuse changes in the thyroid gland can be aggravated by various stresses, overloads, and viral diseases.

Causes of diffuse changes in the thyroid gland

Causes of damage to the thyroid gland include the following diseases:

endemic goiter. The disease occurs when there is a deficiency of iodine, one of the trace elements necessary for the normal functioning of the body;
sporadic goiter. Appears when there is a lack of iodine in the body of a person living in an area with a sufficient content of the trace element in the soil and air. The reason is the pathology of the enzyme system involved in the synthesis of hormones;
Diffuse toxic goiter. A disease that occurs in a severe form, characterized by the development of thyrotoxicosis - pathological hypersecretion of thyroid hormones, requiring immediate medical intervention;
Autoimmune thyroiditis. Damage to the organ, the result of which is the development of hypothyroidism, in the early stages may be asymptomatic. Medical intervention is required if there are obvious signs of thyroiditis - pain in the neck, a feeling of coma or pressure in the throat.

As well as other types of thyroiditis. The causes of diffuse changes in the thyroid gland can also include factors such as unfavorable environmental conditions, various diseases of the body, weakening of the immune system. Hormonal studies and other methods allow to find out the exact cause of the lesion.

Diagnosis of diffuse changes in the thyroid gland

The most accurate method for diagnosing diffuse changes is to test for hormones. First of all, it is necessary to know the level of TSH (thyroid-stimulating hormone) and FT4 (free thyroxine). If no deviations from the norm are detected during hormonal studies, and the gland itself is slightly enlarged, then only prophylactic drugs will be prescribed with mandatory regular examinations - at least twice a year.

With significant diffuse-nodular lesions of the gland, it is necessary to conduct an examination of the level of antibodies to cells and hormones, as a rule, in half of the cases, the cause of the disease is determined by autoimmune processes. Also, to establish an accurate diagnosis, the results of a histological examination and, possibly, consultations with a cardiologist, neurologist and other specialists are necessary.

Treatment of diffuse changes in the thyroid gland

If diffuse changes in the thyroid gland are detected, treatment can only be prescribed by a qualified specialist - an endocrinologist. Only he can determine the necessary drugs for the patient to correct the level of hormones. Attempts at self-treatment, consisting in the unreasonable intake of medications, can cause disturbances in the functioning of internal organs and pose a threat to the life of the patient.

Methods of therapy depend on the degree of diffuse changes in the organ. So, with a slight increase in the thyroid gland, courses of preparations containing potassium iodide can be prescribed in a strict dosage and terms prescribed by a specialist. A diet that includes a large amount of foods containing iodine, such as seafood, seaweed and others, is also recommended. In case of hypothyroidism, the doctor often prescribes a synthetic analogue of thyroid hormone, prescribes long-term treatment, the unauthorized interruption of which can cause a withdrawal syndrome. Such patients must be registered in the dispensary. If there is a severe diffuse change in the thyroid gland, surgical intervention is indicated, after which the necessary hormone therapy is performed to exclude the recurrence of the disease.

Never self-medicate, even with minor changes in the thyroid gland. Take care of your health! Regularly undergo dispensary examinations with an endocrinologist for the timely detection of possible diffuse changes in the gland.

Often incomprehensible diagnostic terms, for example, "diffusion changes in the thyroid gland" are mistaken for an independent disease. In fact, these are objective data that the ultrasound diagnostician sees on the screen.

Structural changes in the thyroid gland can be observed in the complete absence of any symptoms, but can also be the result of serious diseases. In any case, this is a pathological process that requires accurate diagnosis and adequate treatment.

Diffuse changes indicate that the structure is different from a healthy organ, abnormal ultrasound echoes are distributed evenly.

There are the following reasons leading to diffuse changes in the thyroid gland:

Iodine imbalance. It plays a role, both a deficiency and an excess of this element in the body. In order to maintain the production of active substances, hypersecretion of the thyroid gland begins, as a result of which it increases in size and grows.
The presence of genetic defects leading to autoimmune reactions. Thyroid tissues become inflamed and their structure changes. Pathology develops under the influence of infections and inflammations, injuries, exhaustion, alcohol abuse and smoking.
Complications after a viral infection. Acute or subacute thyroiditis may develop.
Other causes: climate change; being in a zone of increased radiation activity; malnutrition; professional intoxication; diseases of the endocrine system.

Symptoms

Symptoms that accompany diffuse changes in the thyroid gland are different with its hypo- or hyperfunction.

Signs of hypothyroidism:

apathetic mood;
rapid fatigue and decreased performance;
deterioration of memory processes;
problems with hair (brittleness, loss) and nails (brittleness);
a decrease in body temperature may be accompanied by chills;
bowel dysfunction (constipation);
weight gain.

Signs of thyrotoxicosis (hyperthyroidism) are:

increased excitability of the nervous system, manifested in aggressiveness;
tachycardia and arrhythmia;
hypertension;
tremor of the upper limbs;
feeling hot, sweating;
bowel disorders (diarrhea);
weight loss;
ophthalmopathy, edema of the eyelids, blurred vision.

Common symptoms in hyper- and hypothyroidism are a decrease in sexual activity, in women - menstrual irregularities (amenorrhea, oligomenorrhea).

In cases of a significant increase in the size of the body, squeezing of closely spaced blood and lymphatic vessels occurs. Patients complain of pain in the neck and when swallowing, coughing and difficulty breathing may occur.

If these symptoms appear, contact your endocrinologist immediately!

Types of change

Diffuse changes in the structure of the thyroid gland can be of a different nature, depending on which they distinguish:

nodal;
parenchymal;
diffuse focal;
cystic;
expressed;
moderate.

Nodal changes. The epithelial tissue of the thyroid gland (parenchyma) has a follicular structure. The follicles are surrounded by blood and lymphatic vessels and are responsible for the secretion of hormones. Nodal changes in the organ provoke an increase in the size of the follicles, and a parenchymal neoplasm appears inside. Changes can be both benign and transform into a malignant form. For this reason, it is extremely important to control the endocrinologist already in the early stages of the manifestation of nodular formations. Diffuse changes in the parenchyma of the thyroid gland in the later stages are noticeable on palpation.

Diffuse-focal changes in the thyroid gland are the most insidious. If you "start" this problem, the pathology will develop into oncology. Against the background of healthy tissue of the organ, foci are formed - areas that have a heterogeneous structure. These can be cysts, tumor formations (lipomas, adenomas, etc.).

Cystic changes are accompanied by an increase in the thyroid gland in size. They are capsules. Cysts can quantitatively grow and transform into malignant tumors.

A pronounced form of changes has a greatly enlarged organ with a significant deformation of the parenchyma. This often occurs during Graves' disease. Diffuse changes in the thyroid gland according to the type of AIT (autoimmune thyroiditis) are also pronounced and are classified depending on the cause of the appearance.

With moderate changes, the parenchyma increases slightly, and hormonal disorders are not observed.

Diagnostics

An endocrinologist can diagnose these pathological changes during examination and palpation. The size of the gland, the presence of seals, soreness, pulsation are estimated.

Additional diagnostic methods are associated with determining the morphological structure of the thyroid gland and the level of its activity, that is, the production of hormones.

The most effective method is ultrasound diagnostics. Abnormal areas of the organ give darkening (increased echogenicity), heterogeneous echostructure and blurry (fuzzy) contours. This study determines the exact size of the organ.

In cases of controversial data, ultrasound studies do magnetic resonance imaging, computed tomography, x-ray studies and scintigraphy. If diffuse focal changes in the thyroid gland or nodular changes are diagnosed, the patient is biopsied for a histological examination of the pathological process.

The concentration of hormones in the blood (T3, T4) is determined by taking tests. With autoimmune thyroiditis, an increased level of antibodies is observed in the blood.

Treatment

The treatment strategy is worked out by the endocrinologist after an accurate diagnosis has been made.

When diffuse changes in the thyroid gland are insignificant, iodine preparations are prescribed. Levothyroxine is prescribed for hypofunction. Hyperthyroidism is treated with drugs that suppress the production of the hormone - thyreostatics. Acute inflammation is treated with antibiotics.

In the case of pronounced diffuse changes of a parenchymal nature, radioactive iodine is used. Its isotopes destroy overgrown follicles.

If, as a result of diffuse changes in the thyroid gland and a significant increase in the size of the organ, neighboring tissues and organs are squeezed, a partial resection of the gland is performed or it is completely removed. After such an operation is necessary.

Prevention

A healthy lifestyle is of great importance in prevention: a balanced diet (the mandatory inclusion of foods rich in iodine), sports, avoiding alcohol and smoking, good rest.

If you have a family history of thyroid pathologies, you need to pay closer attention to your health. Try to avoid stressful situations.

It is especially important to take multivitamin iodine-containing complexes for people living far from the sea or ocean.

All people over 35 years of age should have a consultation with an endocrinologist once a year..

Diffuse focal changes in the thyroid gland at the beginning of their development differ little in symptoms from the manifestations of a cold, and people rarely turn to an endocrinologist in a timely manner. Therefore, it is undesirable to ignore medical recommendations about the planned ultrasound diagnosis of the thyroid gland. After all, the detected pathology at an early stage requires less financial costs and time for its treatment.

Features of the normal structure of the thyroid gland

The thyroid gland is an endocrine organ weighing up to 50 g with a developed circulatory system. It has a left smaller and a right larger cone-shaped lobe up to 60*20 mm in size, which are connected in the middle by an isthmus 0.5–0.8 cm long.

Features of the anatomy of the thyroid gland are within the normal range in adults, if the functions of the gland are not impaired:

may have a greater weight or size;
there are 1 or 3 shares;
located above, below the neck or in the retrosternal space.

Thyroid tissue is formed from thyrocytes (A-type cells). They form the walls of cavity follicles 0.02–0.3 mm in size and fill them with colloid. Between themselves, these rounded cells are connected by a tissue of type C cells. In case of dysfunction or changes in the gland, elements A or C can be transformed into oncocytes, from which a benign or malignant tumor is formed.

Types of diffuse changes in the thyroid gland and an explanation of the term

When reading the results of an ultrasound, the entry “diffuse change in the thyroid gland” comes up, and many are puzzled by what it means. This diagnostic term refers to an extensive (spread over the entire or most of the thyroid gland) pathological modification of the thyroid tissue. Transformation can affect the cells and / or membrane of the gland, which will lead to a deviation from the norm of its shape, density, size and other physical parameters.

In ultrasound diagnostics, seven types of diffuse changes in the thyroid gland are distinguished:

In fact, each type of diffuse change is a symptom of a specific thyroid disease. Therefore, the endocrinologist should deal with the decoding of ultrasound.

Reasons for diffuse changes

Doctors did not reliably determine the cause of diffuse changes in the endocrine gland. Doctors suggest that its development in the thyroid gland causes:

iodine deficiency;
lack of trace elements and / or vitamins;
radiation;
pathology of the pituitary or hypothalamus;
neck injuries;
bad ecology, work with harmful substances;
violation of the blood supply to the gland;
autoimmune disorders;
genetic disorder;
heredity;
failure in the mechanism of hormone production.

Thyroid disease can provoke a diffusely focal or other change in the organ. This is inflammation of the thyroid tissue (thyroiditis), goiter, tumor, hypo- or hyperthyroidism, thyrotoxicosis, adenoma.

Symptoms and signs of diffuse changes in the thyroid gland

A person has no symptoms of a pathological change in the thyroid tissue in the zero stage, when thyrocytes or C-type cells begin to transform. The first signs of the process are noted along with a violation of the functions of the gland caused by an imbalance, excess or lack of thyroid hormones. Their severity increases with the progression of the disease.

The first manifestations of diffuse changes due to thyroid dysfunction:

muscle weakness;
increased fatigue;
depressive state;
emotional instability (lability of the National Assembly).

As the functions of the thyroid gland deteriorate, a person develops swelling of the hands, feet or face, and body weight may increase / decrease dramatically due to metabolic disorders. They also note signs of a cold, shortness of breath, increased sweating, temperature, palpitations or arrhythmia, decreased attention, memory.

The appearance of signs of extensive changes in the structure of the thyroid gland is associated with the localization of the gland. An enlarged lobe and/or isthmus puts pressure on neurons, vessels, trachea, esophagus or larynx, which irritates their membrane and reduces the lumen.

Signs of diffuse changes due to an increase in the thyroid gland:

perspiration, sore throat;
often occurring dry cough (not against the background of a respiratory disease);
difficulty breathing or swallowing food;
loss or hoarseness of voice;
varicose veins of the neck.

Diagnostic signs include an increase in the thyroid gland or neck, the appearance of subcutaneous tubercles, and a change in the size of nearby lymph nodes is possible. These changes are detected by visual examination, palpation of the gland, during ultrasound.

Diagnosis of changes in the thyroid gland

After a physical examination, the endocrinologist sends for an ultrasound scan. It is necessary to assess the structure of the thyroid tissue, the shape and size of the gland. This is the initial and accessible method, based on the results of which a further survey plan is drawn up.

Types of ultrasound diagnostics and the minimum cost (in rubles as of May 20, 2018):

Ultrasound with elastography makes it possible to distinguish between benign and malignant changes by the density of thyroid tissue without taking a biopsy. With re-diagnosis, it helps to qualitatively conduct targeted biopsy. Doppler ultrasound makes it possible to study the state of blood vessels and blood flow in the thyroid gland.

Laboratory diagnostics of the functions of the altered gland and the minimum price of the service (in rubles as of May 20, 2018):

TSH level - 180;
total/free triiodothyronine values - 170/200;
indicators of thyroxine total / free - 170/180;
TSH level - 290;
TG values - 200;
T-uptake test (assessment of the absorption of endocrine hormones) - 325;
a comprehensive study of the level of thyroid hormones + antibodies - 860;
screening for the level of thyroid-stimulating hormone and tetraiodothyroxine - 340.

During the cyto-histological examination of the biopsy, a change in the morphology or the degeneration of A and / or C cells into a different histotype is detected. Analysis of thyrocalcitonin or the presence of antibodies to TG and thyroid peroxidase is carried out to exclude / confirm the development of oncological disease.

Ultrasound norms of the thyroid gland and signs of diffuse changes

With all types of ultrasound, the physical parameters of the thyroid gland must correspond to the age norms of weight, size and shape of the gland. Their deviation indicates the development of diseases of a different nature.

Ultrasound signs of diffuse changes in the thyroid gland on a standard ultrasound:

the presence of areas with heterogeneous echogenicity (one or more spots with a color from white to light gray or from dark gray to black);
an increase in the size of the follicle (clearly defined foci in the form of ringed areas with preserved or impaired echogenicity inside);
disturbed echostructure over the entire area of \u200b\u200bthe gland (in the picture, lightening or darkening of gray);
increase / decrease in total volume, fuzzy contour of the thyroid gland;
extensive increase / decrease in the size of the entire gland or its large area.

In the ultrasound image with elastography, diffuse changes are marked in red (with the development of aitis or other pathologies that increase the density of the thyroid tissue) or in blue (in the case of the formation of malignant tumors). With the development of the disease in Doppler ultrasound, a change in the intensity of the red or blue tone indicates a reduced or increased blood flow in the thyroid gland, and the narrowing of the lumen of the vessel additionally confirms the extensive growth of the gland.

Useful video

What is important to know about diffuse changes is announced in this video.

Therapy of diffuse-focal changes

Methods must comply with the protocol for the treatment of the disease that provoked the development of diffuse-focal changes in the thyroid gland.

Basic principles of therapy:

Large nodes, complications of goiter, malignant neoplasms are treated with surgical methods. Cyst enucleation, hemithyroidectomy, resection or complete removal (thyroidectomy) with/without lymph node dissection are performed. After that, it is possible to prescribe a permanent intake of synthetic hormones.

Prevention

To exclude possible causes of diffuse or focal changes in the thyroid gland, you need to monitor the usefulness of the diet, do not miss scheduled examinations by the endocrinologist, do not overwork, correctly get out of stressful situations and treat any nature of the disease in a timely manner.

It is useful to take vitamin and mineral complexes, lead a healthy lifestyle, do gymnastics daily and walk in parks. These preventive measures will support the normal functioning of the gland, increase immunity and make up for the deficiency of nutrients.

Diffuse focal changes in the thyroid gland are the growth of localized areas of tissue, which are distinguished by a change in the structure of the tissues of the gland. If a neoplasm is detected, treatment should be started immediately, otherwise the nodules degenerate into a malignant tumor. Diffuse focal changes lead to the development of hyperthyroidism of the thyroid gland.

In the early stages, diffuse focal changes in the thyroid gland proceed in an asymptomatic form. The patient feels a slight malaise, such a manifestation of the clinical picture is similar to a cold.

As nodular neoplasms grow, malfunctions in the functioning of internal organs are diagnosed, symptoms of hyperthyroidism appear:

General weakness.
Increase in body temperature.
Diseases of the central nervous system (this sign is pronounced: nervousness, irritability, depression).
Disorders in the work of the cardiovascular system.
Increased sweating.

The thyroid gland gradually increases in size, weakly palpable during palpation. However, the slightest inflammatory process can accelerate the development of diffusely focal neoplasms. The thyroid gland begins to increase in size, putting pressure on nearby tissues.

Symptoms are expressed:

Hoarseness of voice (pressure on the vocal cords).
Pain while swallowing food.
Breathing problems.
Tachycardia.
Exacerbation of psychological diseases.
Increased sweating.
Lethargy.
Inattention/loss of memory.

Identification of the disease at an early stage guarantees a positive result of treatment, without serious consequences for the body.

Modern medicine is unable to find out the cause of the development of diffuse focal changes.

Factors contributing to the development of the disease:

genetic predisposition;
unfavorable ecological situation (living near an endemic focus);
unbalanced diet (“intentional” starvation, fast food);
penetrating radiation (liquidators of accidents at nuclear power plants);
inflammatory (autoimmune) processes;
violation of processes that stimulate the production of hormones;
acute iodine deficiency.

Neoplasms diagnosed by ultrasound examination differ in structure and nature of origin.

A cyst is a benign neoplasm characterized by the content of colloidal fluid inside the tumor capsule.
Adenoma is a benign nodular neoplasm that develops against the background of hyperactive thyroid gland. As a result of exposure to pathogenic factors, the tumor mutates into thyroid cancer.
Teratoma is a benign neoplasm resulting from the degeneration of embryonic cells.
Hemangioma is a benign neoplasm consisting of involuting cells of mesenchymal origin.
Paraganglioma is a tumor originating from the cells of the peripheral nervous system.
Lipoma is a benign neoplasm consisting of a fatty layer that develops against the background of metabolic disorders.
A cancerous tumor is a malignant neoplasm that develops from the epithelial layer of the thyroid gland.

Diffuse focal changes develop against the background of a violation of metabolic processes, in particular, changes in the work of the endocrine system:

Thyroid adenoma.
Goiter of the thyroid gland (nodular form / mixed type).
Oncological diseases of the thyroid gland

Diagnosis of diffuse focal changes should be a signal for an endocrinologist, since pathology indicates the development of a tumor process in the body.

The patient, in turn, should take the doctor's words with maximum responsibility and fulfill all his appointments for examination, and then undergo a course of treatment and follow all recommendations.

To establish a diagnosis in modern medicine, there are several methods that use the latest modern medical equipment. After the initial examination, the endocrinologist prescribes a number of studies.

Each type of study has its own characteristics:

Primary inspection. The endocrinologist performs palpation of the anterior cervical region, the size of the thyroid gland is determined. If the condition of the thyroid gland causes suspicion in a specialist, the patient is sent for an additional examination. Visual examination methods help to identify the pathology of the organ.
Ultrasound examination, in which the doctor receives information about the size of the organ, its position and echogenicity.
Magnetic resonance or computed tomography. This study microscopically accurately assesses the structure of the thyroid gland.
Treatment depends on the results of the examination. If the gland is functioning normally, the hormones are normal, then a periodic examination in the form of an ultrasound scan is prescribed 2-3 times a year.

And if a hormonal imbalance suddenly occurs, then medications are prescribed. For complex treatment, you need to follow a diet that contains the required amount of iodine.

Radioiodine therapy is prescribed after the presence of malignant neoplasms is established. Treatment begins after the removal of the thyroid gland, either completely or partially.

Whatever diagnosis the endocrinologist makes, do not despair. Properly prescribed treatment and responsible implementation guarantees a positive result. In addition, medicine does not stand still. Treatment methods are updated every year, the pharmaceutical industry offers new, more effective drugs.