The normal thyroid gland is impalpable. The
term goiter (Latin, Gutter = the throat) is used to
describe generalized enlargement of the thyroid
gland. It is a ductless gland. It is an unique gland
among all endocrine glands; it is the largest of all
endocrine glands, weighing about 25 grams It is
amenable to direct physical examination due to its
superficial location. The incidence of clinically
apparent thyroid swellings in general population
is 4-5%. Biosynthetic defects, iodine deficiency,
autoimmune disease, nodular disease can lead
to goiter, though by different mechanisms,
especially MNG (Multinodular goiter) which
is due to iodine deficiency is prevalent in India.
Grave’s disease and Hashimoto’s thyroiditis
are also associated with goiter. In addition,
various forms of thyroid enlargement; physical
examination should prompt further evaluation
to identify its cause. More sensitive methods of
detection such as CT scan, thyroid ultrasound
and pathological studies reveal thyroid nodules,
reserving ultrasound for monitoring nodule size
or as an aid in thyroid biopsy. Otherwise, FNA
(Fine Needle Aspiration) cytology should be the
first step in the evaluation of a thyroid nodule.
FNA (Fine Needle Aspiration) cytology has a
good sensitivity and specificity. The distinction
of benign and malignant follicular lesions is
often not possible using cytology alone. In this
study much emphasis is placed on the clinical
presentation of thyroid swellings and the role of
pathological investigations in the management
of thyroid swellings. Treatment modalities
of thyroid swellings depend on the clinical
presentation, investigations and pathological
evaluation of thyroid swellings.