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Thyroid (Expert Forum)
Cold Thyroid Nodule
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
Cold Thyroid Nodule
by ChiliConCairn, May 02, 2007 12:00AM
Hey everybody. I'm just looking for some advice about my thyroid condition.
In June of last year, my doctor discovered a lump on my neck. I went for an ultrasound and then had a needle biopsy done on it in October 2006. These two tests led to the conclusion that the lump was a benign thyroid nodule, about 2 cm. by 2 cm. in size. In February 2007, I went for a thyroid scan and learned that it was a cold nodule (not functioning). I've been to an endocrinologist about all of this, and he wants to wait and see what happens with the nodule. He wants to schedule me for another biopsy in the fall of this year.
Basically, what I'm worried about is the validity of the needle biopsy done on the nodule. A surgeon (not a thyroid specialist) performed the needle biopsy, and the endocrinologist I was referred to after that was surprised to hear that the surgeon had only gone in with the needle 1 or 2 times - he seemed to think it should be done at least 5 times to get enough samples. That's when he ordered the scan and we learned it was a cold nodule (more likely to be cancerous than a hot one). I'm just worried that his decision to not do anything until the fall might be based on incorrect results from that needle biopsy.
I'm an 18 year old female with no history of thyroid issues in my family, and no history of radiation exposure. A couple times a week, my neck will hurt around where the thyroid nodule is and up to my ear on that side, which really scares me. I told the endocrinologist about the pain, but it was pretty much ignored. I'm looking for answers on what to do - should I ask for another needle biopsy sooner, or is it safe to wait until fall? Is it normal to feel a sharp pain where the nodule is?
In June of last year, my doctor discovered a lump on my neck. I went for an ultrasound and then had a needle biopsy done on it in October 2006. These two tests led to the conclusion that the lump was a benign thyroid nodule, about 2 cm. by 2 cm. in size. In February 2007, I went for a thyroid scan and learned that it was a cold nodule (not functioning). I've been to an endocrinologist about all of this, and he wants to wait and see what happens with the nodule. He wants to schedule me for another biopsy in the fall of this year.
Basically, what I'm worried about is the validity of the needle biopsy done on the nodule. A surgeon (not a thyroid specialist) performed the needle biopsy, and the endocrinologist I was referred to after that was surprised to hear that the surgeon had only gone in with the needle 1 or 2 times - he seemed to think it should be done at least 5 times to get enough samples. That's when he ordered the scan and we learned it was a cold nodule (more likely to be cancerous than a hot one). I'm just worried that his decision to not do anything until the fall might be based on incorrect results from that needle biopsy.
I'm an 18 year old female with no history of thyroid issues in my family, and no history of radiation exposure. A couple times a week, my neck will hurt around where the thyroid nodule is and up to my ear on that side, which really scares me. I told the endocrinologist about the pain, but it was pretty much ignored. I'm looking for answers on what to do - should I ask for another needle biopsy sooner, or is it safe to wait until fall? Is it normal to feel a sharp pain where the nodule is?
Doctor's Answer
by Mark Lupo, M.D., May 03, 2007 12:00AM
, May 03, 2007 12:00AM
It is possible to get an adequate sample with 2 needle passes technically, but would be most comfortable with this if done by ultrasound guidance and only in small nodules -- 2cm is a medium nodule and I would recommend repeat FNA under US guidance and see no reason to wait until the fall. most cold nodules are benign though. Pain radiating to the ear is not uncommon with thyroid irritation. Would also test thyroid antibodies to see if there may be some chronic inflammation in the thyroid.
Hi
If I was you I would go and get another FNA done quickly. They should have stuck the needle in at least 4-6 times. I also have a cold nodule and am awaiting surgery.
All the best..
Justin
k =))