When a thyroid nodule appears, it is often the starting point for a series of tests that can take time and generate anxiety. To avoid this, a few hospitals have implemented the diagnosis within a day.
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Nearly 10,000 cases of thyroid cancer are discovered each year in France.
–The Gustave Roussy Institute offers a “Home thyroid nodules in 1 day”, dedicated to people with one or more thyroid nodules. The objective is to quickly specify the nature of the thyroid nodule and to propose treatment, if necessary.
For the past few months, Miloud Djafer’s thyroid has harbored a seemingly benign nodule, but lately his nodule has grown in size.
“Are you embarrassed by your nodule?, asks Dr Livia Lamartina, endocrinologist at Gustave Roussy hospital in Villejuif.
“Indeed when I lie on the right side I feel a weight on the trachea”, explains Miloud Djafer.
Extremely frequent nodules
Thyroid nodules often cause fairly inconspicuous signs. Their discovery is usually made at random during an examination.
“Last year I had a back pain following a herniated disc and my doctor sent me for an MRI to check, that’s when we discovered a nodule at the level of the throat”, says Miloud.
“Thyroid nodules are extremely common. If we take the general population, we do systematic ultrasounds or images, in you it was the MRI, we risk finding it in one in two people. actually malignant nodules, is estimated to be 5%. Even benign nodules can increase in size “, explains Dr Livia Lamartina.
1st step: consultation and palpation
During this consultation, a questionnaire determines risk factors such as the presence of familial cancer. Palpation of the nodule provides a first assessment.
“It’s very flexible, very mobile, I can also feel the nodes but there are no nodes that would be increased in size. This is a good thing., comments Dr Livia Lamartina.
When the consultation is over, a caregiver applies a pain reliever cream to him because Miloud is going to do a series of examinations.
2nd step: ultrasound
On cervical ultrasound, the doctor examines the size of the nodule, its shape, the regularity of the contours and looks for the presence or absence of calcification.
“The left lobe of the thyroid is here occupied by a nodule which is there. I am going to delimit it with my finger, the nodule will have a tissue portion that we can recognize here with different small gray and white dots. A cystic portion which is liquid black, rather reassuring. The nodules which will be disturbing are the gray nodules, see dark gray. It is these nodules which will be classified 4 or 5, that is to say potentially malignant “, explains Dr Salma Moalla, radiologist at Gustave Roussy hospital.
3rd step: thyroid fine needle aspiration
It is the cytologist’s turn to intervene to collect thyroid cells. Two fine needle aspiration are performed to avoid missing any cancer cells.
The samples are immediately examined in an adjacent room. After a first staining step, the slides are sifted under the microscope.
“Normal thyroid cells will have nuclei of small sizes, with very regular oval or round contours. While cancerous thyroid cells will have very large nuclei with irregular contours, see other more specific details”, explains Dr Voichita Suciu, anatomocytopathologist at the Gustave Roussy Institute.
In less than 4 hours, Miloud can finally be fixed on the nature of his nodule.
“I am announcing the result of the fine needle aspiration which fortunately confirms the benignity of this nodule. This is good news”, confirms Dr Livia Lamartina.
“When she says it’s benign, we heave relief”, concludes Miloud.
5,897 punctures performed between 2008 and 2019
In Miloud’s case, only ultrasound monitoring is advised. If his nodule becomes too troublesome, he may decide to have it removed.
5,897 consecutive punctures were performed between 2008 and 2019 during the diagnostic day of thyroid nodules in Gustave Roussy.
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