EDP column by Professor Ketan Dhatariya
“I have recently noticed a lump in my neck and my GP tells me this is probably a thyroid cyst. What is this?”
The thyroid is a gland that sits in the neck producing a hormone called thyroxine. The gland is made up of lots of cells that store the hormone in a jelly-like material called colloid. Occasionally, these cells can produce a lot more of this material than is needed, or the areas of colloid can join together to make a bigger bag or jelly-like material.
Any bag of fluid in the body that is lined by the cells from which the fluid comes is called a cyst. These are commonly found in other areas of the body, such as the ovary or breast.
It is very likely that your GP will ask for an ultrasound of our neck to confirm the diagnosis. If the scan does show that you have a cyst or a lump in the thyroid gland then you may be sent to the hospital for further evaluation. This may involve another ultrasound scan, but this time they may put a needle into the lump to get a few cells to have a look at under the microscope. If there is a lot of fluid in the lump, then they may try and suck the fluid out at the same time – a procedure called aspiration.
If the cells all look normal then it is very likely that you will need another ultrasound in 3 or 4 months time to see if the lump has come back or has changed at all. If it is still there, then another needle biopsy will be done to ensure that there are no abnormal cells present. If the cells are normal in appearance looking down the microscope then you can be reassured. If, however, either not enough cells were identified to be able to give reassurance, or the cells look abnormal in anyway, then you may be asked to see a surgeon because there is always a risk that this lump may not be normal and will need to come out.
The vast majority of people have harmless lumps in their thyroid but most are very small, and so cannot be felt. If you feel that you do have a lump in your neck that you can feel, or is painful or changing in size or shape, then it is best to get this checked out by your GP who will be able to decide if you need to see a specialist or not.