What does uneven echogenicity of the thyroid parenchyma mean?

During a recent physical examination, 40-year-old Mr. Li saw an uneven echo of the thyroid parenchyma on the B-ultrasound. He didn't understand what was going on. In fact, the echo of the thyroid gland is uniform under B-ultrasound. If it is uneven, it may be a polar adenoma with nodules, which should be taken seriously. Of course, the patient still needs to undergo further examination to determine the specific situation. After all, there are many abnormal conditions in the body.

Patients with nodular goiter usually discover it through physical examination or seek medical treatment after discovering a lump in the neck. Physical examination may reveal nodules larger than 1 cm, which are usually soft or tough, with a smooth surface and clear boundaries, and can move up and down with swallowing. Thyroid function test indicators were within normal range. Ultrasound examination shows that the thyroid gland is normal or enlarged, and one or both sides of the thyroid gland may have single or multiple nodules. These nodules may be cystic, mixed, or solid; they are oval in shape. There may be a halo around the nodule. The shape may be irregular; the boundaries may be unclear; the blood supply may be rich; solid nodules may have coarse calcifications with acoustic shadows behind them, but are generally not accompanied by microcalcifications.

The only way to cure nodular goiter is surgical treatment, but not all nodular goiters require surgical treatment. Generally, surgery is only considered when the nodules in nodular goiter are at least 20mm, or are suspected to be malignant, or are compressive, or are located behind the sternum, or are secondary to hyperthyroidism, or affect appearance, work, and life. If the above situation does not occur, it is recommended to follow up with B-ultrasound every six months. Drugs are not very effective in treating nodular goiter.

Thyroid adenoma is a common benign tumor arising from the thyroid follicular epithelium. It is often discovered accidentally and is more common in young and middle-aged women. The tumor grows slowly and moves up and down with swallowing. Macroscopic observation: Mostly single, round or quasi-round, with a diameter of 3cm to 5cm. The cross-section is mostly solid, dark red or brownish yellow in color, and may be complicated by hemorrhage, cystic changes, calcification and fibrosis. It has a complete capsule and often compresses the surrounding tissues.

Key points for diagnosis and differentiation of thyroid adenoma: ① The former is often multiple nodules without complete capsule; the latter is generally solitary with complete capsule. ② The follicles in the former are inconsistent in size and are generally larger than normal; the latter is the opposite. ③ In the former, there is no compression of the surrounding thyroid tissue, and similar lesions are found in the adjacent thyroid gland and the nodule; in the latter, there is compression of the surrounding thyroid gland, and the surrounding and adjacent thyroid tissues are normal.