Ultrasound Pictures “Goitrous Nodule”

  A patient with a goiter may be in such poor general health that the signs and symptoms suggest neoplasia. New swelling may signify a fast-growing thyroid carcinoma, intrathyroid hemorrhage, or the rapid growth of a thyroid nodule. Rapid progression of dyspnea may indicate bleeding into a thyroid carcinoma.

~ Clinical manifestations: palpable, nontender swelling in the neck, often visible.
  There may be dyspnea with stridor serious enough to require intubation. If dyspnea
  is of long standing, the patient may be in a debilitated condition.
~ Diagnosis “ultrasound Pictures of Goitrous Nodule: History, sonography. If intubation is required, it should be  followed by tracheoscopy.
~ “Ultrasound Pictures” findings:
  Enlarged thyroid gland, with or without a discrete nodule
  The trachea may be narrowed or obstructed.

Goiter with internal bleeding:
enlarged, nonhomogeneous thyroid gland (TG) with an irregular anechoic area (arrow, identified as a fresh hemorrhage by CDS). The trachea (TR) is narrowed by the goitrous nodule (arrows). Presumptive diagnosis: thyroid carcinoma. Clinically, there was rapid progression of dyspnea requiring emergency intubation

Endoscopy demonstrates tracheal narrowing by the tumor (same patient as in). A nodule has narrowed the trachea at the end of the endotracheal tube (arrows), preventing successful extubation. Histology p simple goiter with internal bleeding (possibly iatrogenic following catheter placement in the internal jugular vein).