Update: October 2018
A thyroid cyst is a disease characterized by
the appearance in the body tissue of benign tumor
formations filled with homogeneous colloidal content
(colloid cyst of the thyroid gland) and dense formations
(complex or complicated cysts).
These states are also called thyroid nodes and cysts.
glands. Their difference is that the cyst has a cavity,
filled with fluid, while the nodes are actually composed of
altered glandular cells. The sizes of cysts are often small (less than 1
cm), but can increase significantly, and this can happen
With значительном разрастании кисты и определении в ней плотных
elements need to be specifically examined for
malignant tumor. In this case, the doctor will prescribe a biopsy.
components of the cyst. In the structure of the incidence of the population frequency
cyst development is 1-5% of the total number of patients with
нарушениями функций glands.
Withчины возникновения кисты
Simple cysts can be the result of exposure to a multitude of
factors from viral infection to simple blockage of the duct gland
in view of the individual anatomical features of the structure of the organ.
With развитии инфекционного заболевания, сопровождающегося
gland inflammation, a cyst can develop as a secondary
Complex cysts contain fluid and dense particles and have similar
symptoms with colloidal formations. To risk factors and causes
cysts on the thyroid gland include:
- Cancer, radiation and chemotherapy
- A cyst may form as a result of hemorrhage.
- Malnutrition (dystrophy) of the gland
- As a result of the increase in her follicles
- With недостаточном поступлении йода с пищей
- Autoimmune diseases accompanied by inflammatory
gland changes (goiter Hashimoto)
- Radiation exposure in childhood
- Age over 40 years
- The presence of a thyroid cyst in parents, brothers or
- Cystic formations in the thyroid gland in women are found
4 times more often than men.
- Residents of regions with
insufficient amount of iodine in food and water.
- In patients undergoing exposure to ionizing radiation in
for 1 calendar year, the thyroid cyst develops in
2% of cases.
Symptoms of thyroid cyst
Patients with cysts of small size (up to 3 mm) do not mark
no manifestations of the disease and feel completely healthy
by people. Most of them learn about the disease only after
identify them by a physician upon examination. As the size increases
The symptoms of a thyroid cyst become more pronounced.
The first manifestation of a progressive cyst is a “lump” in the throat.
Also for the first time, a cyst can be suspected by the appearance of an enlarged
education on the neck, which is easily felt through the skin. TO
Other common symptoms include:
- Difficulty breathing (due to compression of the trachea with a cyst);
- Pain in the gland area, may spread to the lower jaw
- Pain when swallowing or inability to swallow food;
- The change in timbre (rarely observed, due to
compression of an enlarged cyst specific nerve fibers).
There are several stages in the development of the disease:
- Stage of cyst formation. Asymptomatic. Disease
at this stage is detected by chance during prophylactic
- Stage of growth. With скоплении большого объема жидкости в полости
cysts its size gradually increases, which leads to the development
characteristic symptoms. The doctor may suspect the presence of the disease
already at visual examination. The diagnosis is easily confirmed by
- Stage of resorption. With удовлетворительном состоянии иммунной
system disease passes on its own, and the cyst is exposed
scarring, without causing severe disturbances of the state of the body.
With злокачественном течении заболевания кисты могут
перерождаться в раковую tumor. Such formations have a dense
consistency and distinguished by rapid uncontrolled growth. Also
it is noticed that the malignant course of the disease is more often
accompanied by a change in voice due to the rapid growth of the cyst.
A common concomitant symptom of the disease is
dysfunction of the thyroid gland, characterized by
or decreased hormone production. Due to dysfunction
glands in the progressive course of the disease patients note
chronic fatigue, weight loss, deterioration of immunity. With
The development of these symptoms requires additional treatment.
research for the presence of malignant cancer
With осложненном течении кисты в области измененной ткани
edema and development of bacterial flora appears, which leads to
inflammatory changes and accumulation of pus. Symptoms
adhering infections are increasing acute pain
in the neck, swelling, fever. Characteristic symptom
is an increase in cervical lymph nodes.
Main method Diagnostics – this is visualization using ultrasound. WITH
using ultrasound, determine the size,
the structure of the cyst and surrounding healthy tissue. This method
allows not only to diagnose a cyst with high accuracy, but also
conduct differential diagnosis with adenoma, nodular goiter and
Биопсия кисты held для определения типа кисты и исключения
злокачественного process. With взятии биопсии используется
тонкая игла, которая held в кисту под контролем УЗИ.
The procedure is not particularly difficult and is carried out under
local anesthesia. For more accurate diagnosis, taking material
It is produced from several cyst departments or from various cysts. By
the nature of the cyst content obtained during a biopsy is judged on its
- Yellow, purple, or dark brown color of fluid in the cyst.
indicates uncomplicated course;
- The presence of pus in the cyst indicates adherence
Samples are examined microscopically to detect cancer.
cells. TOиста щитовидной железы характеризуется наличием опухоли из
неaltered glandular cells. These results are obtained in 60%
Злокачественное течение подтверждается на биопсии в 5% cases.
Byграничный результат отмечается в 20% cases. With этом у
most patients with re-examination found
cancer cells. With недостаточном количестве взятого материала
biopsy research is not informative and requires
Puncture of a cyst may be accompanied by its complete emptying with
the subsequent introduction into the cavity of sclerosing substances. The
The method can significantly reduce the number of surgical
interventions and achieve recovery early on. Puncture
produced under ultrasound control, which ensures a low percentage
failed attempts and injury to healthy tissue. With анализе
cyst contents, special attention is paid to the presence of atypical
cells indicating the development of malignant cancer
As additional methods are used:
- TOомпьютерная томография для определения структуры крупных
- Angiography for the prevention of vascular complications;
- Laryngoscopy with hoarseness and other changes
- Bronchoscopy to assess the condition of the trachea during cyst growth
up to large sizes;
- TOонтроль уровня гормонов щитовидной glands.
TOак лечить кисту щитовидной железы?
Effective treatment of benign thyroid cyst
is an emptying by puncture followed by the introduction
sclerosing substances. This is a non-invasive procedure that can
Repeat with relapse development.
With условии, что обнаруженная киста не является злокачественным
образованием, held консервативная терапия. Appointments
- drugs for regulating thyroid hormones,
- as well as anti-inflammatory, metabolic
- and improves blood circulation to reduce swelling and reduce
Антибактериальная терапия held при присоединении инфекции
and requires the exact identification of the type of pathogen and its determination
antimicrobial susceptibility. Medicamentous
therapy is more effective in the early stages of the disease and allows
significantly reduce the frequency of surgical interventions. Only
The attending physician determines how to treat a thyroid cyst.
each individual patient.
TOогда показано хирургическое лечение?
- With прогрессирующем росте кисты или при присоединении
severe symptoms in the form of respiratory disorders and difficulties with
swallowing method of choice is surgical treatment of cysts
- With повышенном риске перехода кисты в злокачественную опухоль
or if confirmed laboratory data are available
held незамедлительно, вне зависимости от стадии заболевания и
sizing cysts. In this case, conservative therapy is not
held, так как повышается вероятность ухудшения состояния
patient and the development of severe cancer.
Can I delete a cyst?
And although in most cases, thyroid cysts
benign, but their “behavior” is unpredictable:
- In some cases, they do not give negative dynamics for years.
- In others, they are growing rapidly.
- Thirdly – they pass by themselves.
- Usually the reason for going to the doctor is the growth of a cyst to the size
(over 3 cm), visible to the eye, and causing deformation of the neck,
hoarseness or loss of it, lump in throat, breathing disorder
and functions of swallowing, neck pain.
If a cyst is less than 1 cm in diameter, it is only observed, with
its increase is carried out with a puncture followed by cytological
research. If after emptying the cyst in it again
content is accumulated, the question of its removal is solved. None
warming compresses or lotions on cysts put in no way
case it is impossible, since it can provoke inflammation.
Surgical treatment for malignant disease is usually
includes bilateral resection of the thyroid gland (removal of a larger
parts of both of its shares). Byсле данной операции обязательно held
careful monitoring of thyroid hormone levels and
If necessary, its correction with the help of medicinal
hormonal drugs (thyroid hormones).
A frequent complication of such an operation is impaired function.
vocal cords with partial loss of voice. If the patient has
a cyst of the left thyroid lobe is diagnosed, then an operation
held только на пораженной стороне (то же и в случае с
defeat of the right lobe). Removal of thyroid cyst
is made through a small incision on the neck in the area of the thyroid
Remote education undergoes histological examination
to confirm the benign process. This allows
carefully plan further treatment.
The postoperative period is mild. Return to normal
life occurs within 1-2 days, it is not required
physical activity restrictions.
The peculiarities of treatment in pregnant women include the exception
radiological methods of research. Biopsy and surgery
treatment during pregnancy is not contraindicated. When planning
treatment needs to take into account the relative risks and benefits. With
the presence of a clear indication of the operation is recommended in
second trimester of pregnancy. With отсутствии выраженных симптомов
compression of adjacent organs or dysfunction of the thyroid gland
лечение held в послеродовом периоде.
Cysts that have a benign course have a positive
prognosis and with the right treatment pass without consequences for
the patient. In many cases, patients do not even need to undergo
treatment. Enough testing in dynamics.
Heavier course and prognosis for the life of the patient has
malignant course in which a cyst is reborn into a cancerous
tumor. The risk of malignancy also increases if
a thyroid cyst is diagnosed in a child (14–40% of cases,
compared to 5% in adults).
The percentage of treatment efficacy in patients with malignant
course of the disease is about 80% in the early stages and
significantly reduced with the development of metastases and tumor germination
to nearby organs.
Автор: TOоробов Никита Александрович врач-анестезиолог