Overview
The thyroid gland is a 20-60 gram light organ, which lies around the esophagus at the neck, below the larynx. Its task is to produce the thyroid hormones thyroxine and triiodothyronine, which are essential for survival. These two hormones are needed to regulate the body’s metabolism.
The thyroid gland reacts very sensitively to external influences and can change its structure as a result. For example, an enlargement of the thyroid gland can increase its volume up to 2 liters. Patients then develop a huge goiter of skin and tissue.
The original term for an enlargement of the thyroid gland was goiter, nowadays the term goiter is mostly used. An enlargement of the thyroid gland does not necessarily have to be accompanied by an altered metabolic situation. Rather, the thyroid hormones continue to be produced at a “normal” level, so that one speaks of a euthyroid metabolic state.
If an overactive thyroid gland is added to the enlargement of the thyroid gland, one speaks of hyperthyroidism, and if it is underactive, one speaks of hypothyroidism. A goiter is divided into different stages according to its external appearance. According to the AWMF guidelines, it is divided into: Stage 0: no goiter, followed by stage 1a, a palpable goiter that is not visible to the eye.
This is followed by stage 1b, a goiter that becomes visible when the head is thrown back to its maximum. Stage 2 is a goiter that is visible with normal head posture, and stage 3, as the last stage, a goiter that is very strongly enlarged and is virtually visible at a distance of several meters. This classification was introduced to enforce a standardized definition of thyroid enlargement.
However, since only the external appearance of the goiter is described, the classification does not provide any information about the actual function and metabolic state of the thyroid gland. Therefore, the thyroid gland is described in more detail, for example on the basis of its location, function, and morphology. The position can be eutopic or dystopic.
Eutop describes – from the Greek from “eu” = good, and “topos”, the position – a correct, i.e. physiological position in front of the esophagus, under the larynx, and not in the thorax, or at another unphysiological place. This position would then be described as dystop (from Greek “dys-” = bad). Furthermore, the function of the thyroid gland may be euthyroid, i.e.
normal, hypothyroid, i.e. too weak, and hyperthyroid, i.e. too strong. For the patient, however, the description of the morphology is sometimes most important.
Here one divides into struma diffusa, struma nodosa. The former describes a diffuse, uniform enlargement of the thyroid gland, with homogeneous growth. Struma nodosa describes a nodular enlargement of the thyroid gland, in which nodules are already present. Depending on the number of nodes, a uninodosa goiter is also described, and a multinodosa goiter.
