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Heterogeneous nodule with normal labs
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Heterogeneous nodule with normal labs

Hi,

I am a 36-year-old woman who had a hysterectomy in 2006. In the past year, I have had weight gain and fatigue. I was at the doctor for a follow up on neck and shoulder pain when I mentioned to my doctor that I had pain from my ear down to my shoulder on the right side, I figured it was related to the bulging disc in my neck. The doctor felt my neck from my ears all the way down my neck. He thought my neck felt full. He questioned me about thyroid problems in my family. My family history includes: my Grandma having her thyroid removed due to hyperthyroidism, my aunt having hypothyroidism and my cousin having her thyroid removed due to cancer. I had lab work previously for my thyroid, which was normal. My TSH was 1.2 and my Free T4 was .90. He ordered an ultrasound that showed that I have a small heterogeneous solid nodule (5x6x7mm) involving the lower pole of the left lobe. My thyroid is normal size measuring: the right lobe is 4.4 x 1.7 x 1.6 cm and the left lobe is 4.4 x 1.7 x 1,6 cm with the isthmus measuring 3mm. They are suggesting another ultrasound in three months. I am wondering if I should be more concerned and should I see an endocrinologist? Also, what do the U/S results mean? I am new to Florida and have no idea where to go. Thanks for your time.
97953_tn?1193367871
This is a small 7 mm nodule that likely can be followed over time.  The overall size of the thyroid is normal.  Usually we would repeat ultrasound in 6 months, 3 months is not unreasonable may be too soon.  With your family history may be reasonable to consult with an endocrinologist.  Typically, fine-needle aspiration is not performed for such a nodule based on your description of a 7 mm heterogeneous solid nodule without a history of a first-degree family member having thyroid cancer or a history of radiation exposure to your neck
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I wanted to add my lab for Ionized calcium was low (0.88) and wondered if this was related to thyroid problems or not? Thank you in advance.
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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