Thyroid Ultrasound > Top 10 Pathology > 2. Goiter and Adenoma

Goiter and Adenoma

The most common lesion in the thyroid is the hyperplastic nodule, also termed a colloid or adenomatous nodule. The etiology of thyroid glandular hyperplasia includes iodine deficiency and disorders of hormone synthesis.

On sonography, hyperplastic nodules have a wide spectrum of appearances. They are most often isoechoic, but can also be hypoechoic and commonly undergo cystic and hemorrhagic degeneration. Larger solid masses may be entirely echogenic. Degeneration of hyperplastic nodules may also produce dystrophic calcification and manifest as either coarse internal calcification or peripheral ‘‘eggshell’’ calcification. For discussion on cytstic nodules, refer to the previous page.

The term goiter is used when hyperplasia leads to overall increase in the size of the thyroid gland. Multinodular goiter, which is composed of multiple hyperplastic nodules with varying degrees of colloid, necrosis, or hemorrhage, is generally heterogeneous in appearance with multiple masses of varying size and echo texture.

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