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Biruni Üniversite Hastanesi Endokrinoloji ve Metabolizma Hastalıkları Uzmanı Dr. Öğr. Üyesi Erdal Kan, tiroid nodüllerine ilişkin açıklamalarda bulundu. Dr. Kan, tiroid nodül lerinin tiroid bezi nde yer kaplayan, çevresindeki normal tiroid dokusundan kıvam olarak farklı oluşumlar olduğunu söyledi.
"ÇARPINTI, KİLO KAYBI VE TERLEME NODÜL BELİRTİSİ OLABİLİR" Dr. Kan, sözlerine şöyle devam etti: "Nodüllerin belli bir büyüklüğü geçmedikçe, hormon yüksekliğine sebep olmadıkça herhangi bir belirtiye sebep olmazlar. Tiroid nodülleri genellikle muayene veya ultrason sırasında belirti vermeden tespit edilir. Eğer nodül çok büyük ise boyunda şişlik ve bası semptomları dediğimiz nefes darlığı ve yutkunmada zorluğa sebep olabilir. Nodülleri bir kısmı tiroid hormonu üretebilir. Bu hastalarda da tiroid hormon fazlalığına bağlı çarpıntı, kilo kaybı ve terleme gibi belirtiler görülür".
Tiroid nodüllerinin sık rastlanılan bir durum olduğuna dikkat çeken Dr. Kan, "50 yaş üstünde USG ile yüzde 50 gibi yüksek bir sıklığı vardır. Bu sıklıkta olması önemli bir durumdur. Nodül tespit edildiğinde genellikle 2 soruya cevap ararız. Birincisi nodülün hormon üretip üretmediği, ikincisi ve daha önemli olan ise nodülün iyi ya da kötü huylu olup olmamasına bakarız" ifadelerini kullandı. "KADINLARDA, ERKEKLERE GÖRE 2- 3 KAT DAHA FAZLA GÖRÜLÜR" Tiroid nodül lerinin her yaşta görülebileceğini söyleyen Dr. Kan, "Sıklığı yaş arttıkça artar. Kadınlarda görülme sıklığı daha fazladır. Yapılan çalışmalarda kadınlarda görülme sıklığı erkeklerin 2-3 katı civarındadır. Tiroid nodül gelişiminin en önemli sebebi iyot eksikliğidir. İyot eksik bölgelerde nodül görülme sıklığı artmaktadır. Genetik faktörlerde bazı hastalarda azda olsa etkendir" dedi.
Dr. Kan, "Tiroid boynun ön kısmında bulunduğu için elle muayenede tiroidin yapısı hakkında fikir sahibi oluruz. Belli bir büyüklüğü geçmedikçe fizik muayenede nodüllerin tespit edilmesi zordur. Tiroid nodül lerinin teşhisinde altın standart yöntem tiroid ultrason udur. Ultrason ile hem muayenede tespit edemediğimiz nodüller görülür hem de nodülün yapısı ve karakteri hakkında fikir ediniriz. Tiroid patalojisi düşünülen her hastaya tiroid ultrasonunun yapılması gerekmektedir" diye konuştu.
"TİROİD KANSERİNDEN EN ETKİLİ KORUNMA YÖNTEMİ DÜZENLİ TAKİPTİR" Tiroid kanserlerinin genellikle nodül olarak karşımıza çıktığını belirten Dr. Kan, "Nodüllerin önemli bir kısmı iyi huylu olsa da bazı durumlarda yakın takip edilmesi gerekir. Bunlar; nodülün sert olması, hızlı büyümesi, boyunda lenf bezlerinde şişme olması, ultrason da koyu görülmesi (hipoekoik), düzensiz sınırlı olması, kanlanmanın artması ve mikrokalsifikasyon gibi durumlarda yakın takip edilmesi gerekir. Bu hastalarda nodülden ince iğne aspirasyon biopsisi yapılarak nodülde kanser olup olmadığı mutlaka araştırılmalıdır. Tiroid nodül leri; bası semptomlarına sebep olmuyorsa, hormon üretmiyorsa ve kanser değilse genellikle tedavisiz takip edilir. Bası semptomlarına sebep olacak kadar büyükse (genellikle 4 cm üzeri) ve kanser ise tedavisi ameliyattır. Toksik nodül dediğimiz hormon üreten nodüllerde ameliyat veya radyoaktif iyot tedavisi uygulanabilir" açıklamalarında bulundu.
Tiroid nodüllerinin önemli bir kısmının iyi huylu olduğunun altını çizen Dr. Kan, "Ancak her nodül düzenli takip gerektirir. Bu nedenle bu hastaları ilaçsız ve cerrahiye gerek olmadan takip etmekteyiz. Bu hastaları tanı anından itibaren 6 ay ara ile ultrason ve tiroid hormon değerlerine bakarak takip ederiz. Takipte nodül boyutunda, fonksiyonunda ve karakterinde değişiklik olmadıkça müdahaleye gerek yoktur" dedi.