Goiter
Updates to Article Attributes
Goitre (rarely thyromegaly) refers to enlargement of the thyroid gland. It can occur from multiple conditions. Clearly the absence of thyroid enlargement does not preclude significant thyroid pathology.
The definition of a goitre depends on age and sex; below are the upper limits of normal for thyroid gland volume1
- adult males:
2512-18 mL9 - adult females:
1810-15 mL9 - 13-14 years: 8-10 mL1
- 3-4 years: 3 mL1
- neonate: 0.8-1.5 mL1
Epidemiology
The prevalence of goitre varies widely depending on the level of iodine deficiency. In severely iodine-deficient areas the prevalence may be as a high as 80%. Goitre is more common in women (M:F = 1:4) and incidence declines with age 5.
Pathology
The thyroid gland may become so enlarged that it becomes a substernal (retrosternal) goitre.
Aetiology
The causes of goitre are diverse 2,3:
- non-toxic simple goitre (e.g. from iodine deficiency)
- Graves disease
- multinodular goitre
- Hashimoto thyroiditis
- thyroid cancer
- goitrogens
- drugs: lithium, amiodarone, etc.
- diet: cabbage, sprouts, etc.
- depositional disease, e.g. amyloidosis
- miscellaneous, e.g. Plummer-Vinson syndrome
Radiographic features
Ultrasound/CT
- each lobe normally measures 4,9:
- length: 4-7 cm
- depth:
<21.3-2 cm - isthmus ≤0.5 cm deep
Thyroid volume can be estimated by measuring each lobe and applying the following correction factor for an ellipsoid formula 6:
- height (cm) x width (cm) x depth (cm) x 0.529*
* various correction factors between 0.494-0.554 have also been proposed 6,9
-
volume (excluding isthmus, unless its thickness is >3 mm)610-15 mL for females12-18 mL for males
History and etymology
Goitre derives from the old French "goitron"meaning gullet. Goitron comes from the Latin "guttur" meaning throat.
Differential diagnosis
See main article: midline neck mass
-<p><strong>Goitre</strong> (rarely <strong>thyromegaly</strong>) refers to enlargement of the <a href="/articles/thyroid-gland">thyroid gland</a>. It can occur from multiple conditions. Clearly the absence of thyroid enlargement does not preclude significant thyroid pathology.</p><p>The definition of a goitre depends on age and sex; below are the upper limits of normal for thyroid gland volume <sup>1</sup>:</p><ul>-<li>adult males: 25 mL</li>-<li>adult females: 18 mL</li>-<li>13-14 years: 8-10 mL</li>-<li>3-4 years: 3 mL</li>-<li>neonate: 0.8-1.5 mL</li>- +<p><strong>Goitre</strong> (rarely <strong>thyromegaly</strong>) refers to enlargement of the <a href="/articles/thyroid-gland">thyroid gland</a>. It can occur from multiple conditions. Clearly the absence of thyroid enlargement does not preclude significant thyroid pathology.</p><p>The definition of a goitre depends on age and sex; below are the upper limits of normal for thyroid gland volume:</p><ul>
- +<li>adult males: 12-18 mL <sup>9</sup>
- +</li>
- +<li>adult females: 10-15 mL <sup>9</sup>
- +</li>
- +<li>13-14 years: 8-10 mL <sup>1</sup>
- +</li>
- +<li>3-4 years: 3 mL <sup>1</sup>
- +</li>
- +<li>neonate: 0.8-1.5 mL <sup>1</sup>
- +</li>
-</ul><h4>Radiographic features</h4><h5>Ultrasound/CT</h5><ul><li>each lobe normally measures <sup>4</sup>:<ul>- +</ul><h4>Radiographic features</h4><h5>Ultrasound/CT</h5><ul><li>each lobe normally measures <sup>4,9</sup>:<ul>
-<li>depth: <2 cm</li>- +<li>depth: 1.3-2 cm</li>
-</li></ul><p>Thyroid volume can be estimated by measuring each lobe and applying the following correction factor for an ellipsoid formula <sup>6</sup>:</p><ul><li>height (cm) x width (cm) x depth (cm) x 0.529*</li></ul><p>* various correction factors between 0.494-0.554 have also been proposed <sup>6</sup></p><ul><li>volume (excluding isthmus, unless its thickness is >3 mm) <sup>6</sup><ul>-<li>10-15 mL for females</li>-<li>12-18 mL for males</li>-</ul>-</li></ul><h4>History and etymology</h4><p><strong>Goitre</strong> derives from the old French "goitron"<strong> </strong>meaning gullet. Goitron comes from the Latin "guttur" meaning throat.</p><h4>Differential diagnosis</h4><p>See main article: <a href="/articles/midline-neck-mass">midline neck mass</a></p>- +</li></ul><p>Thyroid volume can be estimated by measuring each lobe and applying the following correction factor for an ellipsoid formula <sup>6</sup>:</p><ul><li>height (cm) x width (cm) x depth (cm) x 0.529*</li></ul><p>* various correction factors between 0.494-0.554 have also been proposed <sup>6,9</sup></p><p><strong style="font-size:1.5em; font-weight:bold">History and etymology</strong></p><p><strong>Goitre</strong> derives from the old French "goitron"<strong> </strong>meaning gullet. Goitron comes from the Latin "guttur" meaning throat.</p><h4>Differential diagnosis</h4><p>See main article: <a href="/articles/midline-neck-mass">midline neck mass</a></p>
References changed:
- 9. Dighe M, Barr R, Bojunga J et al. Thyroid Ultrasound: State of the Art Part 1 - Thyroid Ultrasound Reporting and Diffuse Thyroid Diseases. Med Ultrason. 2017;19(1):79-93. <a href="https://doi.org/10.11152/mu-980">doi:10.11152/mu-980</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28180201">Pubmed</a>
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