Diffusive Thyroid Changes

Diffusive changes in the thyroid gland are changes in the tissues of the entire thyroid gland, which is revealed in the course of ultrasound (ultrasound).

With certain transformations in iron with the help of ultrasonic diagnostics, a change in the ability of the thyroid tissue to reflect sound is noted (called echogenicity). In this case, it can be said that all gland reflects ultrasonic waves not in the same way as a healthy organ should do. Further, a more accurate diagnosis is required, which will reflect the true state of the thyroid gland. Therefore, "diffuse changes in the thyroid gland" - this is just a term that is used in the technique of ultrasound diagnosis and can mean a different in nature of the disease of the gland.

[1], [2], [3]

Causes of the diffusive Thyroid Changes

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 soil and water are poor in iodine, this greatly affects the appearance of diffuse changes in the thyroid gland. These regions in medical practice are called endemic, that is, where a particular disease has a massive spread. Therefore, it can be said that thyroid diseases in these areas are common.

• Change in the hormonal balance of the thyroid gland.

Disruption of the reproduction of thyroid hormones (more or less than the amount necessary for the body) affects the change in the appearance of the gland and the structure of its tissue. In this case, there may be an increase in the organ, which occurs evenly and in all directions, which is called a diffuse enlargement of the thyroid gland.

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

Usually, the inflammatory processes in this organ are of an autoimmune nature. That is, violations in the thyroid inflammatory nature are due to the fact that human immunity due to a number of pathological causes begins to become aggressive to the thyroid gland. Such a disease is called chronic autoimmune thyroiditis (or lymphomatous thyroiditis). The course of this disease is characterized by the formation in the body of antibodies and lymphocytes, which damage the cells of their own thyroid gland. It should be noted that in the normal state of the human immune system, the production of antibodies occurs to the penetration of foreign elements into the body.

• Unbalanced nutrition.

When there is a lack of food rich in iodine, changes in the structure and functioning of the thyroid gland can be observed. The same anomalies arise if the food of the patient in large quantities contains food products, which contain substances that inhibit the production of thyroid hormones. Such products include cabbage (white, colored, Brussels), corn, beans, turnips, peanuts, soybeans.

• Change in the environmental situation in the region, which happened 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 adjacent territories, caused widespread changes in the thyroid gland in the population.

Diffuse thyroid changes are a manifestation of the following diseases:

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

[4], [5]

Symptoms of the diffusive Thyroid Changes

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

1. The appearance of heterogeneity in the tissue structure and various density of the gland surface, which exclude the appearance of focal transformations in the thyroid gland.
2. 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 goiter - a strong pathological increase in the volume of the thyroid parenchyma.
3. Appearance of fuzziness, blurriness of external contours of the given organ.
4. There are changes in the functioning of the thyroid gland, which are accompanied by a violation of the hormonal background. Such changes are of two types:
   • hyperthyroidism - manifested in increasing 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;
• the appearance of brittle nails;
• presence of permanent colds;
• presence of constant chills;
• presence of constant sluggishness, 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 of intellectual abilities;
• the emergence of problems with cognitive processes - remembering and reproducing information, concentration of attention, general diligence;
• the appearance of changes in weight, which are not related to the quantity and quality of nutrition of the patient;
• the appearance of disturbances in the functioning of the endocrine system, which cause hormonal imbalance in the body;
• the emergence of problems with the sexual sphere of man, the reduction of sexual functions of the body;
• the presence of permanent, chronic constipation, not related to the diet of the patient.

[6], [7], [8]

Forms

[9]

Diffusive changes in the parenchyma 

A parenchyma is a certain set of cells of an organ that carries a certain functional load. The parenchyma differs from the stroma in that it has its origin from various types of tissue. If the stroma is formed only by the cells of the connective tissue, the parenchyma may include hemopoietic tissue (for example, in the spleen), epithelial tissue (for example, various epithelial glands)), nerve cells (or nerve nodes), and so on.

Parenchyma and stroma are in dense "cooperation" and they can not be divided, since it is such integrity that allows the body to work normally. The stroma is a kind of skeleton for the organ, and the parenchyma fills each organ with a certain functional purpose.

The thyroid parenchyma is an epithelial functional tissue that consists of actively dividing cells. The parenchyma of the thyroid gland consists of follicles, namely, bubbles of various sizes, which are the units of the structure and functioning of this tissue. On average, each follicle is equal to the value of forty to fifty micromicrons. Each of the vesicles 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 four iodine molecules in the structure of the thyroxine unit. In the abbreviated form, thyroid hormones, respectively, are designated as T3 and T4. The hormone T4, secreted by the gland, in the cells and tissues of the body is transformed into a hormone T3, which is the main substance that affects human metabolic processes.

Diffuse changes in the thyroid parenchyma are changes in the entire tissue of the parenchyma, which are associated with an increase in the thyroid gland. Thus it is necessary to consider, that all parenchyma of a gland has undergone transformation, and these changes are distributed in regular intervals on all area of an organ. Visually, this phenomenon can be observed as an increase in the volume of the thyroid gland in all directions.

Diffusive changes in the thyroid parenchyma are detected by palpation on examination by an endocrinologist. After passing the ultrasound, which appoints a specialist, in some cases, the diagnosis is "diffuse changes in the thyroid parenchyma." Such a diagnosis can be made even in the absence of any other signs of thyroid disease. In these cases, the patient still does not bother, but the gland itself is already functioning under tension. Therefore, any additional negative incentives - stresses, emotional and physical overloads, infectious diseases - can trigger the progression of the disease. In this case, the functioning of the thyroid gland is disrupted, 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 quantity in the blood of a person, which adversely affects the work of the whole organism, and also leads to the emergence of many symptoms of a health disorder.

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

[10], [11], [12]

Diffuse structural changes 

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

With diffuse enlargement of the thyroid gland, the structure of the gland changes: it becomes denser and increases in volume. In the early stages of a diffuse increase in the thyroid, symptoms of such changes are usually absent. In this case, changes in the structure of the body are noted when visiting a doctor-endocrinologist, who conducts examination and palpation of the gland. After detecting anomalies in the thyroid structure, a 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 various diseases that caused it, the results of the analyzes may be different. The initial stage of the disease can be accompanied by a normal hormonal status, that is, the absence of any disturbances in the reproduction of thyroid hormones. At the same time, an adequate amount of thyroxin and triiodothyronine, which produces iron, is noted in the laboratory tests.

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

After carrying out laboratory tests (or together with them), an ultrasound examination (ultrasound) is performed to diagnose and prescribe the appropriate therapy.

Progression of the thyroid disease leads not only to a change in the structure of the gland tissues, but also to malfunctioning of the whole organism. The very first "blow" takes over 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 reproductive system is disrupted. Exchange processes in the body also suffer, as the thyroid hormones regulate the exchange of calcium in the body. As a result, the patient can develop multiple caries and osteoporosis.

[13],

Diffusive focal changes

Diffusive-focal changes in the thyroid gland are an increase in thyroid tissue, in which there is a appearance of foci with a changed structure of the gland tissue. In most cases, these foci are surrounded by glandular tissue of the thyroid gland with an unchanged structure.

Neoplasms that are found on ultrasound may be different in structure and nature of education. These include:

• cysts,
• adenomas,
• teratomas,
• hemangiomas,
• paragangliomas,
• lipomas,
• cancerous tumors.

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

• nodular goiter,
• mixed goiter,
• adenoma of the thyroid gland,
• thyroid cancer.

Detection of diffuse focal changes in the thyroid should alert the doctor and the patient, since this phenomenon may indicate the onset of 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 own characteristic of echogenicity. Such a difference in the parameters of the survey makes it possible to make a diagnosis of ultrasound more accurate and competent.

[14], [15], [16], [17]

Diffusional-nodal changes 

Diffusive-nodal changes in the  thyroid gland  can be detected during palpation of the thyroid gland on reception by a doctor-endocrinologist. This can be done because the location of the gland is superficial, and it is perfectly palpable.

Palpation of the organ is as follows. The patient faces the specialist; while the patient can sit on a chair, stand or lie on the couch. Pressing on the gland in a certain way, the endocrinologist estimates the size of the thyroid gland, the density of its tissue, and also the uniformity of the structure of the organ. At this point, the doctor can find areas with increased density and increased glandular tissue, which are called nodes. Also, a specialist can ascertain diffuse changes in the thyroid gland, that is, a general increase in its volume. After such a preliminary examination, the endocrinologist assigns the patient an ultrasound - diagnosis.

The specialist of ultrasound diagnostics can confirm or refute the previously delivered preliminary diagnosis. Usually, the fears of endocrinologists during the survey are confirmed. If in the course of ultrasound the specialist discovers knots in the glandular tissue exceeding in size one centimeter, this serves as the basis for biopsies of the tissue of the suspicious node. Passage of a similar procedure is prescribed by an endocrinologist after acquaintance with the results of ultrasound diagnosis. And only after carrying out 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 origin of the nodes is parenchymotic, that is, it is associated with an increase in one or more follicles of the glandular tissue of the thyroid gland. A node of the thyroid gland specialists call a neoplasm in the structure of the parenchyma, having its own capsule, which limits the node from the healthy tissue of the organ.

Over a long period of time, diffuse-nodal changes in the thyroid gland can be asymptomatic, and can only be detected by a doctor at the endocrinologist. If the nodes of the thyroid gland greatly increase in size, they begin to influence the functioning of the organs and tissues that are located side by side. For example, patients may complain of a feeling of suffocation, a change in the tone of the voice or the appearance of a feeling of a foreign lump in the throat. Also for large sites it is characteristic to cause various changes in the structure and functioning of the larynx, which can cause painful symptoms.

For a large number of nodes, the process of degeneration of a benign tissue into a malignant tissue is known, which is called the malignization process. What is the nature of this phenomenon, and sometimes it is not known to specialists themselves. Therefore, patients who have diffuse-nodular changes in the thyroid gland should be under constant supervision of endocrinology doctors.

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

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

• nodal colloid goiter,
• cystic fibrosis adenoma,
• carcinomas.

[18], [19]

Diffusive-cystic changes 

Diffusive-cystic changes in the thyroid gland are the presence of cystic lesions in the glandular tissue of the thyroid gland against the background of a general increase in the volume of the organ.

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

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

Cysts are manifested not only in the increase of a specific area of thyroid tissue, which can give the feeling of having a foreign element in the anterior part of the neck. For such neoplasms, the appearance of suppuration from getting a certain infection in the cyst is characteristic. The process of suppuration is accompanied by symptoms of an acute inflammatory process - an increase in body temperature, a general intoxication of the body, the appearance of sharp pain in the area of the cyst and nearby tissues.

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

[20], [21], [22]

Moderate diffuse changes 

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

With moderate diffuse changes in the thyroid gland, there are no foci of compaction of the tissue 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 find that special treatment of the problem is not required. Such a decision can be made only in the case when there are no other symptoms and disturbing physician and patient manifestations of thyroid dysfunction.

It should be remembered that the situation with an enlarged thyroid gland can not be released from 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 send the patient an ultrasound-diagnosis.

Expressed diffuse changes 

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

Expressed diffuse changes of the thyroid are characteristic for the following organ diseases:

• autoimmune thyroiditis,
• Hyperthyroidism in Graves 'disease (Graves' disease).

In some cases, expressed diffuse changes in the thyroid gland are accompanied by focal (nodular or cystic) enlargement of the thyroid tissue.

As a rule, expressed 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 insufficiently or intensively produce certain thyroid hormones, which, on the whole, affects the overall health and well-being of the patient. In addition to disturbing transformations in the gland, patients can complain about problems with the cardiovascular system, nervous system, reproductive organs, bone system and so on. All such ailments are a consequence of the improper functioning of the thyroid gland, the hormones of which affect the functioning of the whole organism.

Expressed diffuse changes in the thyroid gland require compulsory medical treatment, which is prescribed by an endocrinologist after carrying out all the tests and examinations necessary in this case.

[23], [24], [25], [26], [27], [28], [29]

Diagnostics of the diffusive Thyroid Changes

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

• Inspection at the endocrinologist.

When visiting this specialist, the palpation of the front cervical patient is performed. If in the course of this procedure a certain, alarming doctor, a thickening of the thyroid gland is found, the endocrinologist sends the patient to an additional examination. Clarifying procedures will make it possible to specify the diagnosis and choose the most optimal solution for the problem in the form of appropriate treatment.

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

Ultrasound diagnosis or ultrasound (ultrasound) is the most popular method of examination of the thyroid gland. This method of obtaining information on the state of the thyroid gland favorably differs in that it is the most safe diagnostic tool. Computer and magnetic resonance imaging are considered to be more potentially dangerous methods that affect the patient's health and are less likely to be used for these reasons.

In most cases, the diagnosis of "diffuse changes in the thyroid gland" is determined by the patient after the procedure of ultrasound. Indications for conducting such an investigation can be of several types:

• complaints of the patient to their own state of health and well-being and / or feelings and external changes in the front cervical section;
• emerged when examining a patient's suspicion of existing pathologies in the structure of the thyroid gland;
• the existing dysfunction of the thyroid gland, namely the statement of hormonal imbalance in the patient's body, obtained as a result of laboratory tests (blood tests and so on).

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

The diagnosis of "diffuse changes in the thyroid gland" is established if the ultrasound results indicate a change in the echogenicity of the thyroid tissue. In this case, heterogeneity of the organ's echostructure can be detected-a decrease or increase in echogenicity in different parts of the gland, as well as a general decrease or increase in echogenic qualities of the thyroid gland.

Computer or magnetic resonance imaging is good for detecting diffuse or focal lesions of thyroid tissues. The results of these studies are of great validity, because with their help a qualitative assessment of the structure and density of thyroid tissue can be made.

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

[30], [31], [32], [33]

Treatment of the diffusive Thyroid Changes

First of all, it is necessary to recall that treatment of diffuse changes in the thyroid gland can not be carried out independently. Only an endocrinologist and only after a thorough examination has the right to prescribe appropriate therapy. There are cases when an independent choice of drugs led to serious health problems and various complications of the underlying disease.

The choice of strategy for the treatment of diffuse changes in the thyroid gland is affected by the degree of its increase, as well as the type of functional disorders of the organ:

With a certain increase in the thyroid gland without disrupting its function, usually, experts prescribe the intake of potassium iodide. It is also possible to recommend taking iodine-containing foods that help regulate the activity of the thyroid gland without any medication. Such products include:

• sea kale,
• buckwheat grain,
• Red caviar,
• Cod liver,
• persimmon,
• fish fat,
• sea fish (herring, salmon, halibut, flounder, tuna, cod),
• various seafood (crabs, squid and shrimp),
• sunflower oil, better unrefined,
• feijoa,
• apple seeds (four doses of seeds contain a daily dose of iodine) - they must be cracked and thoroughly chewed.

In this case, it must be remembered that such treatment (application of potassium iodide) should be conducted in courses with interruptions. The duration of the course of therapy, as well as a break, is indicated by a specialist-endocrinologist.

• If there are problems with the functioning of the thyroid gland, for example, with a decrease in the production of hormones, the doctor can prescribe the patient the use of synthetic analogues of the thyroid hormone. These include preparations of Eutirox and Levothyroxine. Perhaps, also, the appointment of medicines of a combined nature, for example, Thyreotome.

During the course of treatment, it is necessary to periodically check the level of the hormone in the blood. This is done using laboratory blood tests.

• With the nodular form of the goiter, if the nodes rapidly increase and become larger, surgical intervention is necessary. Since such a state of thyroid gland can lead to squeezing of surrounding organs and tissues and the violation of their proper functioning.

After the operation, specialists prescribe the reception of thyroid hormones. This measure is necessary to ensure a stable remission and prevent a relapse of the disease.

• It must be remembered that in the case of treatment of thyroid problems, the endocrinologist resorts to strictly individual therapy, which may not be appropriate in a number of other similar cases. The specialist takes into account the individual characteristics of the patient, which are inherent only in his body, as well as the specific course of the disease.

Prevention

In the conditions of general increased ecological disadvantage of human living conditions, it will not be superfluous to take preventive measures that can prevent disruption of the activity (or structure) of such an important organ as the thyroid gland.

Prevention of diffuse changes in the thyroid gland should include methods that are aimed at individual and mass improvement of the situation with the disease.

• Individual measures for people living in areas unfavorable for thyroid are:
  • eating iodized salt (it should be remembered that iodized salt should be added to dishes only after the end of the thermal treatment of products, as iodine evaporates when heated);
  • The presence in the food of food, which in large quantities contain iodine.
• Individual preventive measures are necessary for patients after surgery on the thyroid to prevent recurrence of the disease. These include taking hormonal drugs, which are appointed by an endocrinologist.
• Preventive measures to prevent diffuse changes in the thyroid gland include complex anti-stress therapy. These methods include the use of sedatives, relaxation training and auto-training, respiratory antistress practices and yoga.
• Concern for human immunity is an important factor in maintaining a healthy state of the thyroid gland. Therefore, it is necessary, in prophylactic purposes, to take vitamin-mineral complexes, which the doctor should choose.
• Even in such a seemingly simple matter as the use of vitamins, you should not do self-medication, but seek advice from specialists who are versed in this matter.
• With a hereditary predisposition to diseases of the thyroid gland (or endocrine system) it is necessary to undergo regular examinations with an endocrinologist. If the specialist notices the symptoms that will alert him, he will be able to refer the patient to an additional diagnostic examination.
• If there are certain signs of a change in thyroid status, for example, even a slight increase in the thyroid, it is necessary to consult with an endocrinologist. The basis for addressing to a doctor can be the appearance of emotional states such as anxiety, increased anxiety, fatigue, constant fatigue, problems with sleep, and so on. It is better to take certain steps at the beginning of the alleged disease and stabilize your condition than to treat at later stages of the process.
• It is necessary to undergo a regular ultrasound examination (ultrasound) of the thyroid gland to patients who have a history of a diagnosis associated with thyroid disease. This also applies to people living in ecologically unfavorable regions.

Most endocrinologists agree that such a survey should be performed once a year for all persons over the age of thirty-five.

[34], [35], [36],

Forecast

The prognosis of diffuse changes in the thyroid gland in the early stages of the disease is favorable. This is possible if the treatment is done promptly and correctly.

After surgical treatment, with nodular goiter, the appearance of postoperative hypothyroidism - the insufficiency of the hormones produced by the thyroid gland. In this case, the administration of hormonal drugs is prescribed to avoid the appearance of such a condition.

Also, such patients should avoid direct sunlight in large quantities on the thyroid gland and the entire surface of the body in order to avoid relapse of the disease.

The prognosis of the development of the disease will be favorable if you do not engage in self-medication and do not use iodine preparations without consulting your doctor. The same precaution is not superfluous and with respect to food products containing iodine in large quantities.

Diffusive changes in the thyroid gland is a diagnosis that requires careful care of your own health and adherence to the recommendations of specialists. And only in this case a person with a similar diagnosis can hope for a normal and full life, in which his shchitovidka will not cause him trouble.

[37], [38], [39], [40]