Help understanding my thyroid ultrasound report

[LearningasIgo]

I have had blood work and a thyroid scan/uptake that both are showing hyperthyroidism.  
Can you please help me understand my ultrasound results.  
They read as follows:
INDICATION:  Thyroid Toxicosis and Goiter
Real time ulrasonography of the thyroid was performed and reveals both right and left lobes of the thyroid to be enlarged and moderate to markedly heterogeneous in texture throughout.  The isthmus is also enlarged and heterogeneous in texture.
Right lobe of the thyroid is 4.9x1.8x1.4cm in size.
There are two hypoechoic nodules in the right lobe of the thyroid.  In the mid-pole of the right lobe of the thyroid, a 7x5x3mm nodule is seen and in the lower pole of thyroid, a 4x5x2mm nodule is seen.  Also in the mid-pole of the right lobe of thyroid, a 6x5x3mm complex nodule is indentified.
Left lobe of the thyroid is 5x1.4x1.2cm in size.
There are two nodules in the left lobe of the thyroid.  These measure in the upper pole 5x5x3mm in size and in the lower pole, 1.2x0.8x0.9cm in size.
Lateral to the left lobe of the thyroid, there is what appears to be a lymph node present.  This appears enlarged measuring 1.9x0.7x1.4cm in size.  This could represent two adjacent lymph nodes.  This would be amenable to percuntaneous fine needle aspiration biopsy wiht sonographic guidance, as deemed appropriate clinically.
IMPRESSION:
Heterogeneous appearance to both right and left lobes of thyroid as described above.  Both lobes of thyroid appear enlarged.  There are hypoechoic nodules seen in the right and left lobe of the thyroid as descibed abov as well as complex cyst in the lower pole of the right lobe of the thyroid.  These nodules and bysts appear to be approx less than 1cm in size.  There is however lateral to the left lobe of the thyroid a complex, probable lymph node seen as described above.  This is amenable to percuntaneous biopsy as deemed appropriate clinically.
Can you tell me what to expect?

[Mark Lupo, M.D.]

I would recommend seeing a thyroid specialist who does his/her own ultrasound.  The thyroid is not significantly enlarged and if hyperthyroid, this is likely Graves' (less likely thyroiditis).  Either of these can cause lymph node swelling and both can cause a nodular (or pseudonodular) appearance of the thyroid.  Check out thyroidologists.com or aace.com or thyroid.org to find a specialist near you.  It is not clear from the post that FNA biopsy is required, but certainly an ultrasound specialist should evaluate this.

[LearningasIgo]

Thank you so much for getting back to me.  I wasn't sure if the results were suggesting a FNA biopsy because it said "This would be amenable to percuntaneous fine needle aspiration biopsy wiht sonographic guidance, as deemed appropriate clinically".  

I will research some information on those suggested websites.  I don't like needles and ofcourse I was scared when I heard the word biopsy (because I just assumed they would be checking for cancer).  

The more research I do the more confused I get because everything is saying that I am hyper but I have almost all the symptoms of hypo.

Anyway, thank you again so much for your help!!