Scintiscan of the Thyroid Gland

tuha_23_n.jpg: Female teenager with a node of the left lower pole of the thyroid gland which is distinctly palpable. In the Tc 99m- or 123 I-scan a minimal to missing accumulation of the tracer is recognizable in the same place. The diagnosis is an inactive node of the left lower thyroid gland pole. The significance of thyroid scan in childhood concerns the proof of thyroid gland tissue in case of suspected goitre at the tongue base, anywhere else and/or at the normal site; in addition, the recognition of hormonal activity and dignity of thyroid gland nodes in teenagers. As in adults, the work-up examinations of pathologies of the goitre in children include hormonal examinations, ultrasound, and in case of suspected malignancy, fine-needle aspiration. In case of a node of the thyroid gland, a scan is performed with the aim to know if there is no activity at all, normal activity, or hyperactivity in the node; mainly, if the TSH is less than 0.6 mU/L, a scan is useful because in this case inactivity or - less frequently - normal activity is expected in this situation (I owe this picture to Prof. J. Müller-Brand, Head of the Institute of Nuclear Medicine, University Hospital, CH-4031 Basel). A scintiscan is only necessary if no thyroid gland present at the normal site or if there is a suspicion of a malignant thyroid tumor clinically or on ultrasound. Scintiscan of a teenager with a palpable node of the thyroid gland which is also visible on ultrasound.