Pathophysiology of Non-toxic

Nodular Goiter

Predisposing Factors: Precipitating Factors:

Diet
Age History of Radiation
Gender Regular intake of
Genetics substances (Goitrogens)
Geographic

Decreased/Suppression of
synthesis of thyroid
hormones

Decreased T4 and T3 in
the body

Negative feedback:
Increased production of
TSH

Heterogeneous growth of
thyroid follicles

Ischemic necrosis of
expanding follicles
 Development of
nodules

Venous outflow  Facial

obstruction of plethora
 Visible and
Thyroid architecture the head and  Engorgement
palpable
loses uniformity neck of neck
mass
(Goiter)
Pressure on  Dysphagia
esophagus
Gradual
enlargement of the Pressure on
Thyroid Gland anterior
(Nontoxic Nodular neck Pressure on  Dyspnea
trachea  Coughing
 Wheezing
Functional
autonomy of Pressure on
recurrent
laryngeal  Hoarseness
TSH receptor gene nerve
mutation

Toxic Multinodular Treatment:

Goiter  Thyroidectomy
 Radioactive Iodine
therapy
 Levothyroxine Therapy
May lead to
Thyrotoxicosis

Thyroid Storm

Heart Failure

Death