Is thyroid type 4a generally benign?

Thyroid 4a is a common classification of thyroid nodules. Generally, thyroid nodules are divided into multiple categories, and thyroid 4a is a relatively common classification. From the perspective of malignancy, the possibility of thyroid 4 being malignant is about 5% to 10%. Therefore, in this case, we must also pay attention and conduct timely reexamination. The reexamination time is about half a year to a year. If the growth is relatively fast, it should be surgically removed in time.

Clinical manifestations

1. Nodular goiter is more common in middle-aged women. When the body's thyroid hormone is relatively insufficient, the pituitary gland secretes more TSH. Under the long-term stimulation of this increased TSH, the thyroid gland undergoes repeated or continuous hyperplasia, leading to uneven enlargement and nodular changes in the thyroid gland. There may be hemorrhage, cystic changes and calcification within the nodule. The size of the nodules can range from a few millimeters to several centimeters. The main clinical manifestation is thyroid enlargement. Multiple nodules of varying sizes can be felt during palpation. The texture of the nodules is mostly of medium hardness. A few patients can only palpate a single nodule, but multiple nodules are often found during thyroid imaging or surgery. Patients do not have many clinical symptoms, generally only discomfort in the front of the neck, and thyroid function tests are mostly normal.

2. Nodular toxic goiter This disease has a slow onset and often occurs in patients who have had nodular goiter for many years. The age is mostly over 40 to 50 years old, and it is more common in women. It may be accompanied by symptoms and physical signs of hyperthyroidism, but the symptoms of hyperthyroidism are generally mild, often atypical, and infiltrative exophthalmos generally does not occur. When palpating the thyroid gland, a smooth round or oval nodule can be felt with clear boundaries and a hard texture. It moves up and down with swallowing, and there is no vascular murmur in the thyroid gland area. Thyroid function tests show elevated thyroid hormone in the blood, which is caused by functional autonomous nodules, and radionuclide scanning shows "hot nodules".

3. Inflammatory nodules are divided into infectious and non-infectious types. The former is mainly caused by subacute thyroiditis caused by viral infection, and other infections are rare. In addition to thyroid nodules, subacute thyroiditis is clinically accompanied by fever and local thyroid pain. The size of the nodules depends on the extent of the lesions and the texture is tough. The latter is mainly caused by autoimmune thyroiditis, which is more common in middle-aged and young women. Patients have fewer subjective symptoms. Multiple or single nodules can be palpated during examination. The texture is hard and tough, with little tenderness. Thyroid function tests often show strongly positive thyroglobulin antibodies and thyroid microsomal antibodies.

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