Recommendations / 15/02/2020

Can a cold nodule turn hot?

If a nodule is composed of cells that do not make thyroid hormone (don’t absorb iodine), then it will appear “cold” on the x-ray film. A nodule that is producing too much hormone will show up darker and is called “hot.” 85% of thyroid nodules are cold, 10% are warm, and 5% are hot.

Do you biopsy hot nodules?

Because cancer is rarely found in hot nodules, a scan showing a hot nodule eliminates the need for fine needle biopsy. If a hot nodule causes hyperthyroidism, it can be treated with radioiodine or surgery.

What is cold nodule in thyroid scan?

A cold nodule is a thyroid nodule that does not produce thyroid hormone. On a radioactive iodine uptake test a cold nodule takes up less radioactive material than the surrounding thyroid tissue. A cold nodule may be malignant or benign. On scintigraphy cold nodules do not show but are easily shown on ultrasound.

What causes hot nodules?

Nodules that produce excess thyroid hormone — called hot nodules — show up on the scan because they take up more of the isotope than normal thyroid tissue does. Hot nodules are almost always noncancerous. In some cases, nodules that take up less of the isotope — called cold nodules — are cancerous.

Can a hot nodule be detected before surgery?

Some physicians will also advocate carrying out a thyroid scan (to detect a hot versus cold nodule) prior to recommending surgery for a patient with abnormal thyroid cytology. Although mostly benign, thyroid cancer has been detected in a small percentage of hot nodules, generally in less than 5% of reported cases, but up to 10% in some series.

Can a thyroid nodule be hot or cold?

Thyroid scans may show that a nodule is hot, warm or cold. Inside the thyroid gland, thyroid cells produce hormones which regulate the body’s metabolic rate. When part of the thyroid enlarges to form a hot nodule, the cells inside the nodule are making too much hormone.

What makes a hot nodule a hot spot?

A hot nodule is defined as a nodular region of the thyroid gland that takes up large amounts of radioactive iodine relative to the rest of the thyroid gland, hence it is visualized as a “hot spot” on the thyroid scan. The majority of hot nodules function autonomously, and have lost their normal ability to be regulated by TSH.

Do you need a tsh for a hot nodule?

Hot Nodule. For this reason, it is important to always have the result of a TSH when investigating a patient for a thyroid nodule. Some physicians will also advocate carrying out a thyroid scan (to detect a hot versus cold nodule) prior to recommending surgery for a patient with abnormal thyroid cytology.

How can a nodule not come out as hot or cold?

Confused! I had a ultrasound done and the results came back with a 7mm X 5 X 4mm solid, ill-defined hypoechoic nodule is identified within the anterior mid pole. So I had a uptake scan done and the results came back with a no hot or cold nodule demonstrated. What could this mean? How could a nodule not come out as hot or cold? Thanks!

Is it possible to diagnose thyroid cancer from a hot nodule?

This can be difficult to diagnose, since fine needle aspiration biopsy of hot nodules will often show follicular thyroid cells, and may not be suggestive of thyroid cancer even if this turns out to be the final diagnosis.