Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Thyroid Ultrasound
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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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Thyroid Ultrasound

I am having trouble understanding my US results.

Date of US:  10-11-06
Findings:  The left lobe measured 3.4CM X 1.5CM X 1.6CM in size and right lobe measured 3.2CM X 1.8CM X 1.8CM in size.  The isthmus appeared unremarkable.  Bilateral solid nodules seen.  Nodule on the left lobe measured .7CM X 1.3CM and nodule on right lobe measured .6CM X .6CM.  Both lobes appeared grainy.
Impression:  Thyromegaly with grainy texture and bilateral solid nodules seen.  Suggest further thyroid evaluation.

So I went to Endo, was told I have Hashimoto's.  I now take .125 Synthroid everyday.  Here is my recent Ultrasound:

Date of US:  10-18-07
The right lobe of thyroid is nonhomogenous in appearance.  It measures 5.24 X 1.84 X 1.44 CM.  The left lobe of the thyroid also nonhomogenous measures 4.77 X 1.22 X 1.68 CM.  The isthmus measures 5.4mm.  Multiple small calcifications and small hypoechoic areas are seen in the thyroid.  Findings could be consistent with Hashimoto's disease.
Findings:  Calcifications and nonhomogeneity of the thyroid.

Lab:
TSH 1.15
Free T4 0.88
Free T3 2.01

Everything I've read on the Internet always mentions calcifications & cancer together.  I read on here previously that it depends on what "type" of calcification.   I'm just worried because last year they said "nodules", this year "calcifications", and nodules were not measured this time.    I am currently waiting to see an endo.  Until then, I'm not sure how concerned I should be.

Thanks!
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This is all probably hashimoto's with the appearance of "pseudonodules" (areas of increased inflammation) last year and an overall decrease in the size of the thyroid (except the length measurements which vary from tech to tech usually) with synthroid.  The "calcifications" are not likely those we associate with cancer when found in a "micro-calcification" pattern within a true nodule.

The key here is who is doing the ultrasound -- if it is an experienced thyroid doctor doing it him/herself then that is the best way to ensure there is nothing that needs FNA.
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