Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Hypoechoic nodules, well-defined on thyroid and one on isthmus
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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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Hypoechoic nodules, well-defined on thyroid and one on isthmus

I just found out through an ultrasound the following results: Several solid nodules bilaterally noted in thyroid.  Hypoechoic right lower pole nodule (well-defined 8 mm in diameter), 19x12 mm medial mid right lobe nodule, 11 x 9 mm upper pole right nodule which is more isoechoic but the others are hypoechoic.  Isthmus nodule also hypoechoic, well-defined, 2.7 x 2.4 cm.  Left side - mid left lobe nodule, 12 x 9 mm.  Thyroid gland size is within normal range, right lobe and left lobe each about 4.5 cm in length.  I am freaking out and have been told to see an otolaryngology instead of an endocrinologist.  My blood test came back all in the normal range.  I am confused since with what I am reading the hypoechoic are more cancerous especially if my thyroid tests are normal.  Any help you can give would be greatly appreciated.
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The labs being normal do not predict anything about the ndoule.
The next step is FNA biopsy of the 2.7cm nodule, 1.9cm nodule and possibly the other nodules depending on more in-depth US evaluation by the doctor doing the FNA.
The FNA should be done with US guidance.
Risk of cancer on average is 5-10%.
Hypoechoic nodules are very common and still, most often benign.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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