Accessed Oct. 31, 2019. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Its mass effect on the trachea results in narrowing best appreciated in the transverse dimension. normal thyroid function continues or returns to normal after treatment. Some thyroid nodules, however, may become large enough to be visible or make it difficult to swallow or breathe. The incidental thyroid nodule. Sometimes, smaller nodules require thyroid surgery for a definitive diagnosis and cure. Sympathetic supply is provided by superior, middle, and inferior cervical ganglia. Necessary cookies are absolutely essential for the website to function properly. 2. Some thyroid adenomas lead to hyperthyroidism. The extra thyroxine can cause symptoms of an overproduction of thyroid hormones (hyperthyroidism), such as: Only a small number of thyroid nodules are cancerous. The sagittal view shows mildly coarse heterogeneous echo texture. Courtesy Ashley Davidoff MD Copyright 2010 94503c.8L, Courtesy Ashley Davidoff MD Copyright 2010 96233c01L.8. We know there is a lot of information on the site and it can be Overview of thyroid nodule formation. (2005) ISBN: 9780781742917 -, 5. From a clinical standpoint, size is an especially important structural characteristic of the thyroid. (2002) ISBN: 9780198605126 -, 9. While most thyroid nodules are not cancerous as noted above, some are (5%, maybe 10%-15% at most). Some patients are good candidates for a scarless thyroid procedure . Gray's Anatomy. Malignant nodules occur in roughly 5% of all nodules. (2011) ISBN: 9780323065382 -, 2. Even though getting a biopsy is not technically difficult (its easy to find a nodule and stick a needle in it), you dont necessarily want to get a biopsy of every thyroid nodule that you see (9). It encloses a short segment of the recurrent laryngeal nerve as it ascends in the tracheo-esophageal groove. But, in order to be on the safe side, its ideal that every patient who has a thyroid nodule undergoes certain tests to ensure that this is the case. For more information about thyroid nodule surgery, please see our article Thyroid Nodule Removal: Top 4 Facts to Know. Although most thyroid nodules are noncancerous and don't cause problems, ask your doctor to evaluate any unusual swelling in your neck, especially if you have trouble breathing or swallowing. The size of the thyroid changes with age. Diagnostic ultrasound: text and cases. Patients should also realize that thyroid biopsies are only as good and reliable as the people performing them and the pathologists who are evaluating the cells. She has a family history of hypothyroidism. The soft densities to the right of the right lobe are related to the patients newly diagnosed lymphoma. Secondly, calcitonin is also produced by the thyroid gland which helps in calcium homeostasis. Potential complications of hyperthyroidism include an irregular heartbeat, weak bones and thyrotoxic crisis, a rare but potentially life-threatening intensification of signs and symptoms that requires immediate medical care. In: Rosai and Ackerman's Surgical Pathology. Figure 1:Thyroid nodule size chart shows that the likelihood for requiring thyroid surgery increases as the size of the thyroid nodule increases. Thyroid cancer is one of the most treatable kinds of cancer. A small nodule with a diameter of less than 1cm is often benign, but if it reaches a size greater than 2 cm, there is an increased risk of cancer. The thyroid gland is composed of a left and right lobe connected in the middle, which extends in a butterfly shape at the base of the neck, underneath the larynx. Most cancerous thyroid nodules are slow growing and may be small when your doctor discovers them. Not all large nodules are bad, and not all small nodules are benign. Placing a rolled towel beneath the upper shoulders can help extend the neck in larger patients or in patients with a low-lying gland. Susan Standring. Accessed Oct. 31, 2019. Nature Reviews Endocrinology. If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland. Illustration of the thyroid wrapped around the trachea in a person's neck showing the normal size of a thyroid and an enlarged size (goiter). Certain factors increase your risk of thyroid cancer, such as a family history of thyroid or other endocrine cancers and having a history of radiation exposure from medical therapy or from nuclear fallout. You can read more about my own personal health journey and why I am so passionate about what I do. Dec. 5, 2019. Having said that, there are some people that will, which is what we are going to talk about now. The image on left is a coronal view of the neck and the b is a transverse view of the thyroid. The changing incidence of thyroid cancer. Stephanie Ryan, Michelle McNicholas, Stephen J. Eustace. A biopsy often referred to as a fine needle aspiration or FNA, is the most conclusive way to test your thyroid nodule. In: Ferri's Clinical Advisor 2020. Your doctor can do this when you visit him/her in the office. 2018; doi:10.1097/CAD.0000000000000617. The thyroid is a butterfly shaped gland located in the throat or neck region, just below the Adams apple. onthe right and.7 1.0cm. Patients worry about thyroid nodule size as these tumors get bigger, cause symptoms, or become noticeable. Tiny nodules, which are less than 1 cm in diameter. If they believe intervention is needed, they may refer you to an endocrinologist to determine if the nodule is cancerous. Furthermore, you dont really want to get a biopsy unless absolutely necessary because there are small risks involved(10) with any medical procedure. Check for errors and try again. 1 ). Epidemiology 22 The limits of normal thyroid volume are 10 to 15 mL for adult females and 12 to 18 mL for (Modified) Back to the table of contents Gastrointestinal Appendix Normal appendix References: Ultrasound can help evaluate a thyroid nodule and determine the need for biopsy. The normal right lobe (a,b) measures 4.6cms (length) x 1.4cms (A-P anteroposterior) X .7 cms (transverse TRV) and the hypoplastic left lobe measures 2.9cms (craniocaudad), by .6cms (A-P) by .7cms (transverse). A newer alternative that the doctor can use to treat benign nodules in an office setting is called radiofrequency ablation (RFA). When the thyroid nodule reaches 4 cm or greater, it will almost certainly require surgical treatment. Elsevier; 2019. https://www.clinicalkey.com. privacy practices. Any enlarged benign-appearing lymph nodes or abnormal-appearing lymph nodes of any size are measured in three planes (anteroposterior, transverse, sagittal). Accessed Oct. 31, 2019. Your entire thyroid can grow larger or it can develop one or more small lumps called thyroid nodules. The normal size of the thyroid gland in adults is 4 to 4.8 cm x 1.0 to 1.8 cm x 0.8 to1.6 cm. Thyroid nodules are growths that occur in the thyroid gland forming a lump or bump within the otherwise smooth, even thyroid. The thyroid is imaged using a high-frequency linear transducer (715 MHz) with the patient lying supine with the neck in hyperextension. As thyroid nodule size increases, the need for surgery does as well. As thyroid nodule size increases, these masses crowd out/replace normal thyroid tissue. Diagnostic and Surgical Imaging Anatomy. Findings: The thyroid gland is high normal in size. Choosing an experienced specialist can mean more options to help personalize your treatment and achieve better results. . Robbins and Cotran Pathologic Basis of Disease. The vast majority more than 95% of thyroid nodules are benign (noncancerous). You can use an ice pack to alleviate any discomfort or swelling. This test is inexpensive, accurate, and pain-free, with results available on the same day. This rounded shape in the transverse dimension is a clue to the presence of the enlarged gland, even before the measurements are taken and evaluated. Ultrasound testing can help you to understand if your thyroid nodule looks suspicious or not. The image shows the artistic rendering of the small hypofunctioning thyroid (gray) the normal thyroid in the middle (pink), and the hyperfunctioning and enlarged thyroid of thyrotoxicosis. You may feel some discomfort or pressure during your FNA as the needle enters your throat, and the area could remain sore for up to 24 hours after the procedure. However, after histopathological results, the patient was counseled for Figure 2. . Figure 2:Thyroid nodule size chart demonstrates relative size and the effects large nodules have on the thyroid gland. Ross DS. If the doctor recommends removal of your thyroid (thyroidectomy), you may not even have to worry about a scar on your neck. Get my free thyroid downloads, resources, and PDFs here. 3 thyroidectomy, but unfortunately he did not turn up. Because many thyroid nodules dont have symptoms, people may not even know theyre there. However, a nodule that is large and hard or causes pain or discomfort is more worrisome. Additionally, this method is excellent to look for thyroid cancer that has spread to lymph nodes in the neck. I also happen to formulate the best supplements on the market (well, at least in my opinion!) These findings suggest age related involution of the gland. The isthmus is normal in size. The thyroid is one of the largest endocrine organs in the body, but on the other hand is smallcompared to most other organs. And this makes a lot of sense, considering the thing you should be worried about is your risk of cancer. The findings are consistent with a thyroiditis. There is growing evidence that low-risk micropapillary thyroid cancers smaller than 1 cm can be followed with observation as an alternative to immediate surgical excision. Clearly, thyroid nodule size matters. These conditions are not termed as abnormal. The Greek shield had a notch cut into it for the chin, and the resemblance of the shield to a particular piece of cartilage in the neck brought about the term "thyreoid cartilage" (the "e" was later dropped). Accessed Nov. 7, 2019. To provide you with the most relevant and helpful information, and understand which You often won't know you have a thyroid nodule until your doctor discovers it during a routine medical exam. Nodules the size of a peanut or pea can also require a biopsy if there are suspicious features noted on ultrasound (more on that in # 4 below). There are no specific anatomic landmarks within the thyroid. The left lobe of the thyroid measures 4.1cms (craniocaudad), by .8 cms (A-P) by 1.1cms (transverse). The normal thyroid weighs approximately 15 to 25 g, with each lobe 4 to 6 cm in length and 1.3 to 1.8 cm in thickness. As noted above, thyroid nodules are common, occurring in 40% of women and 30% of men during their lifetime. Thyroid nodule size does not correlate directly with the cancerous or benign nature of a thyroid tumor. People who undergo thyroid gland surgery may need to take thyroid hormone afterward to keep their body chemistry in balance. The thyroid gland is a single midline endocrine organ in the anterior neck responsible for thyroid hormone production which lies in the visceral spacecompletely enveloped by pretracheal fascia (middle layer of the deep cervical fascia). The sagittal view shows mildl coarsening and heterogeneity of the echoexture. The parathyroid glands lie posteromedially and are sometimes intracapsular. Thyroid nodules are often diagnosed as benign by needle biopsy during a patient evaluation. Accessed Oct. 31, 2019. Measurements should be obtained for each lobe including the anteroposterior, transverse, and sagittal dimensions. Aggressive thyroid cancers are rare with nodules that may be large, firm, fixed and rapid growing. We have even seen rare cases where a small thyroid nodule (less than 1 cm) is a cancer that has spread to lymph nodes in the neck. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Vaccines & Boosters | Testing | Visitor Guidelines | Coronavirus. The normal size, or range of size, of the thyroid gland in adults is 4 to 4.8 cm x 1.0 to 1.8 cm x 0.8 to1.6 cm. A thyroid ultrasound only takes about 10 minutes. branchial cyst with normal thyroid gland. The strap muscles include the sternohyoid and sternothyroid anterior to the thyroid, the sternocleidomastoid muscles anterolateral to the thyroid, and the longus colli muscles posteriorly. The thyroid is a superficial structure in the anterior neck. Symptoms of thyroid cancer include the following: 3. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. These lumps can be solid or fluid-filled, in which case they are referred to as cysts. The first is with a manual exam, usually performed by your doctor. Most thyroid nodules aren't serious and don't cause symptoms. Because the thyroid volume changes with age, the size of . As such it is an important surgical landmark during thyroidectomies to avoid damaging the nerve. The isthmus is2-6mm inA-P diameter and is up to 20 mm. Cancer risk from thyroid nodules is low. Fortunately, thyroid size is easily measured with ultrasound which is a safe and relatively inexpensive tool. Kearns AE (expert opinion). The thyroid is a gland which has a fundamental role in the good functioning of the body system. Sign up to receive the latest and greatest articles from our site automatically each week (give or take)right to your inbox. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Or your doctor may uncover it during a scan that was done for another health reason. Furthermore, the components of ultrasound of the thyroid gland are well established, including the appearance of the normal thyroid gland and thyroid pathology. Other types of thyroid cancer, like anaplastic thyroid cancer, cause a large lump that appears suddenly or develops over a few weeks or months. The esophagus is most commonly located posterior to the left lobe of the thyroid and can contain air ( Fig. measuring 2.0 cm (AP) 1.4 cm (T) 3.1 cm (CC) in size. It escalates up to 50% during the early part of the menstrual cycle. Complications associated with some thyroid nodules include: Hyperthyroidism. #4. These arent usually biopsied. Thus, thyroid nodule size is one reason for benign thyroid nodule surgery. Is it time to panic? The sagittal view shows mildly coarse heterogeneous echo texture. New masking guidelines are in effect starting April 24. each lobe normally measures 4,9: length: 4-7 cm depth: 1.3-2 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 Sonographic normal thyroid lobe measurements (cm) References Cole-Beuglet C. Ultrasonography of the thyroid, parathyroid and neck masses. Report / Delete Reply ann19043 LAHs Linear measurements are the standard for most evaluations, but measurements that portray a volume or mass are also possible using conventional imaging techniques. ThyroidCancer.com is an educational service of the Clayman Thyroid Center, the world's leading thyroid surgery center operating exclusively at the new Hospital for Endocrine Surgery. The normal thyroid gland can also extend over the surface of the carotid, but the anterior contour is typically flat. This category only includes cookies that ensures basic functionalities and security features of the website. A normal ultrasound of the thyroid gland is demonstrated. The gland is mildly heterogeneous. Learn which foods you should avoid if you have thyroid disease of any type. Thyroid cancer. A normal ultrasound of the thyroid gland (a,b) is juxtaposed with the ultrasound of a 78 year female with hypothyroidism (c,d) A diffusely enlarged, heterogeneous thyroid gland is seen in the hypothyroid patient. Vinay Kumar. The patient is a 70 year female who shows diffuse atrophy of her thyroid by this ultrasound examination. Symptoms and signs of the disease depend on the size and location of the goiter. Obviously, thyroid cancer is not nearly as common which means that most people with thyroid nodules do NOT get thyroid cancer. It's unclear why this occurs, but it's not cancerous and isn't considered serious unless it causes bothersome symptoms from its size. In: Sarti DA, ed. Most thyroid nodules don't cause signs or symptoms. I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. The first imaging study used in work-up and evaluation of thyroid nodule size and any thyroid problem should always be an expert, skilled, dedicated thyroid and neck ultrasound. 6. The thyroid ultrasound is a method used to check the size, position and shape of the thyroid gland. Inenlarged lobes, the measurements ranged from 4.0 to11.5 cm. If you find it difficult to eat or breathe due to discomfort or pain in your thyroid region, notify your doctor immediately. Primer of Diagnostic Imaging. These smaller nodules are challenging to biopsy and this should only be done at high-volume centers such as ours. The average weight is 25 g; this is slightly higher in females and may increase during menstruation and pregnancy 7. These arent usually biopsied. It is critical to monitor your thyroid health with regular visits to your physician so they can check your thyroid for the presence of nodules. Thyroid size was measured by ultrasound, and thyroid volume was calculated. This test can also be used to check the number of nodules, thyroid nodule size, and can even reveal what the blood supply to these nodules looks like. Overall prevalence of thyroid nodules in the general population has been estimated as high as 65-68% based on autopsy studies. 3 B). What size is normal for thyroid isthmus A 20-year-old female asked: Thyroid ultrasound the right thyroid lobe measures 4.7 x 1.6 x 2.4cm.the thyroid isthmus measures 7mm.the left thyroid lobe measures 5.2 x 1.6 x 1.7cm? Junji Machi, Edgar D. Staren. This website uses cookies to improve your experience while you navigate through the website. Surgery to remove the gland typically addresses the problem, and recurrences or spread of the cancer cells are both uncommon. Courtesy Ashley Davidoff MD copyright 2010 all rights reserved 93852dc01.8s, The enlarged smooth gland is usually seen in patients with thyrotoxicosis and includes Graves disease, acute thyroiditis and subacute thyroiditis, Courtesy Ashley Davidoff MD copyright 2010 all rights reserved 93852.d03cdc06.81s, A goiter implies a large gland. The first imaging test used in work-up and evaluation of thyroid nodule size and any thyroid problem should always be an expert, skilled, dedicated thyroid and neck ultrasound. Because enlarged benign-appearing lymph nodes are commonly identified in levels IA and IB and are almost universally related to the mouth and not the thyroid, these levels are not included in the standard thyroid protocol. Usually, the superior pole is narrower than the inferior pole giving a pear-like shape to each lateral lobe. (2015) ISBN: 9780702052309 -, 8. As a patient, though, you can use the size of your nodule as a quick and dirty way to assess whether or not you should be worried. Lastly, it should be noted that if suffering from any thyroid disorder, you may also experience weight loss or weight gain, irritability along with the changes in size of the gland. http://www.thyroid.org/hyperthyroidism/. Thyroid. If your thyroid is functioning normally, you shouldnt be able to feel it externally. Because of this superficial location, ultrasound is the imaging modality of choice for evaluation of the thyroid gland. The goiter is overlaid in green and seen displacing the trachea (teal blue) to the right. Finally, ultrasound is also used to perform needle biopsies of thyroid lumps and lymph nodes to see if they are cancerous or not. All rights reserved. Two popular treatments for thyroid nodules are Radioactive Iodine Therapy and Thyroid Radiofrequency Ablation (RFA). Anti-thyroid medications. Nodules the size of a grape or small kiwi usually require a needle biopsy for further information. Ultrasound Courtesy Ashley Davidoff MD Copyright 2010 96233c01.8, A normal thyroid gland in sagittal (a) and transverse (b) planes is juxtaposed on an abnormal atrophied gland(c,d). For these reasons, you really dont want to get a biopsy unless absolutely necessary based on the size of your nodule or based on the features your nodule has on ultrasound testing. Anti-Cancer Drugs. Kellerman RD, et al. The transverse view shows a normal shape. It may lay slightly to the right or left of true midline ( Fig. "Thyroid" derives from the Greek word "" (large oblong shield) and "" (-like) 5. Accessed Nov. 4, 2019. <13 cm is normal. Sonographically, the normal thyroid gland is homogeneously echogenic with increased echogenicity as compared with the adjacent strap muscles. 5th ed. Let us know your question(s) and we will forward it to our surgeons Fisher SB, et al. The endocrine glands are known as ductless glands, as the hormones that are produced are directly released in the blood. The gland is heterogeneous particularly well seen on the sagittal view (c). The biggest fear that most people have when it comes to thyroid nodules is whether or not they should worry about it. Thyroid nodule. But, even if you request the information, you should have your doctor also evaluate this information to help you understand it. To learn more and become a patient, please see our resources below. He is married and has 3 children. Normal Size Range According to endocrinologist Dr. Mark Lupo, normal dimensions for the thyroid gland are 4 to 4.8 x 1.0 to 1.8 x 0.8 to1.6 cm. Normal thyroid lobe dimensions change from birth into adulthood: the length (L or craniocaudal) diameter is 1.8 to 2.0 cm in newborns and 4.0 to 6.0 cm in adults, while the A-P dimension measures 0.8 to 0.9 cm in new-borns and 1.3 to 1.8 cm in adults.22 The limits of normal thyroid volume are 10 to 15 mL for adult females and 12 Ross DS. there are multiple bilateral cysts and nodules. AP diameter 3 cm is abnormal. The list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose and manage thyroid disease correctly! Immediately anterior (superficial) to the thyroid are the strap muscles. The bad news is that a thyroid nodule is not normal and may be associated with other conditions of your thyroid gland. In: Goldman-Cecil Medicine. Unable to process the form. ISBN: 9780702029714 -, elevators, retractors and evertors of the upper lip, depressors, retractors and evertors of the lower lip, embryological development of the head and neck. At Another Johns Hopkins Member Hospital: The Johns Hopkins Thyroid and Parathyroid Center, Webinar: Thyroid Disease, an Often Surprising Diagnosis, Radiofrequency Ablation for Thyroid Nodules. These conditions, if not treated, can lead to quality of life problems such as fatigue, weight gain, and so on. The bottom line is thyroid nodule size is matters. Anatomy for Diagnostic Imaging. Courtesy Ashley Davidoff MD Copyright 2010 93832cL.8. The weight of the gland varies with age, sex, functional status, iodine intake, and geographic location. Less common: Kitahara CM, et al. Restart Medical LLC. A large mostly hypoechoic mass expands the left lobe of the thyroid on the ultrasound of this 54 year female who presents with an enlarged thyroid gland. The patient was a candidate for surgery. . Most common: A growth (nodule) that appears as a visible lump on your neck. This is an easy way to test whether or not you need further testing. These cookies do not store any personal information. The magic number in terms of size is 1 cm or 10mm. Learn more about our sister surgeons at the. Nodules larger than 1 cm with suspicious features are biopsied. Learn more about The Clayman Thyroid Center here. 6789 Quail Hill Pkwy, Suite 211 Irvine CA 92603. 11-. Thyroid ultrasound can help determine thyroid nodule size and whether the nodule is solid or filled with fluid. Hyperthyroidism is caused due to over production of the thyroid hormones; whereas hypothyroidism is caused due to the underproduction of these hormones. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Is your thyroid nodule actually thyroid cancer in disguise? Normal transverse thyroid on grayscale ultrasound. However, the size of the thyroid can vary depending on a number of factors, such as age, gender, and whether you have an underlying medical condition. Thyroid ultrasound is the best and most common method for evaluating the thyroid. The mass is seen on cross sectional CT as an irregularly enhancing mass connected to the thyroid gland on more cranial views. Some thyroid adenomas lead to hyperthyroidism. If you have questions regarding your health you should seek qualified information from a medical professional or your doctor. A nodule with mixed solid-cystic composition of size 3.3 cm x 2.0 cm can be seen in the medial peripheral part of the left lobe. 26th ed. or for our office, we would be happy to help. Reference TSH ranges remain controversial, but for most people, the normal range falls between 0.4 and 4.0 mU/l. For this reason, you never want to judge the risk of thyroid cancer based on the size of your nodule alone. This imaging test uses sound waves to get pictures of the thyroid gland, surrounding tissue and structures, and the lymph nodes in the neck. Very large nodules rarely need to be biopsied because surgery is indicated to remove these lesions based on thyroid nodule size alone. If you have a thyroid nodule AND you have any of these other signs or symptoms, then you may be at a slightly higher risk of thyroid cancer: Let me be clear, though, just having these symptoms does not guarantee that you have thyroid cancer. or to our office, and get back to you as soon as we can. The pathology finding reported a mass measuring 5.5 cm *3.5 cm *7.5 cm, which was evidence of . posteriorly:thyroid cartilage, cricoid cartilage, trachea, posteromedially:tracheo-esophageal groove (containing lymph nodes, recurrent laryngeal nerve, parathyroid glands), superior thyroid artery (from the external carotid artery), inferior thyroid artery (from the thyrocervical trunk), if the inferior thyroid artery arises from the subclavian artery it is referred to as an accessory inferior thyroid artery, superior thyroid vein (drains to the internal jugular vein), middle thyroid vein (drains to the internal jugular vein), inferior thyroid vein (drains via plexus to the brachiocephalic vein). Follow me on Youtube, Facebook, TikTok, and Instagram for up-to-date thyroid tips, tricks, videos, and more. Chaudhary V & Bano S. Thyroid Ultrasound. If you get an inconclusive result then you are stuck in a position where you simply need to monitor the thyroid gland and potentially get a repeat biopsy after some period of time. Since no non contrast CT was performed the peripheral increase in density may be due to enhancement or more likely due to iodine or calcification. Thyroid nodules are solid or fluid-filled lumps that form within your thyroid, a small gland located at the base of your neck, just above your breastbone. Several conditions can cause nodules to develop in your thyroid gland, including: Overgrowth of normal thyroid tissue. This content does not have an English version. Problems can occur when a nodule or goiter produces thyroid hormone, leading to an excess amount of the hormone in the body. Just found this on Google re average size of a thyroid gland: Anatomy. This figure clearly shows an increasing likelihood for surgery as thyroid nodule size increases (independent of other factors). The biggest concern on most peoples minds is probably whether or not their thyroid nodule is actually cancer in disguise. It is estimated that approximately 50% of Americans will have a thyroid nodule by the time they reach 60. include protected health information. (Solid nodules are more likely to be cancerous.) (d). While the risk for cancer and spread to lymph nodes increased with large nodules (10.4%- 22%), not all big nodules are cancerous. The thyroid gland produces hormones like the tri-iodothyronine (T3) and thyroxine (T4).