define ultrasound "inhomogenous echogenicity"

[QueenBTeacher]

I have elevated Thyroglobulin AB (104) but normal range TPO levels.  My thryoid scan shows "upper limits of normal size" with "echogenicity slightly inhomogenous."  I've read that this is typical of Hashimoto's but GP denies this b/c TPO level is 10.62 (normal range <34).  
My ultrasound shows inhomogenous echogenicity. What does this indicate? I have been hypothyroid for 4 years and am currently treated.  I have lupus, as well as a high-risk factor for cancer. (Mom, Dad, brother (age 40), sister (age 53) all died of cancer.  Additionally my fraternal grandmother died young with cancer.  My dad's brother and sister both died at age 50 of cancer.  My first cousin - fraternal side - is my age (53) and has had thyroid cancer only last year.

I had contacted GP to check on thyroid levels, because of an increase in symptoms and an uncomfortable feeling in my neck. The TSH, T3 and T4 levels are all normal.  After the ultrasound results, my GP said "thyroiditis" but not Hashimotos, and she is sending me to ENT.  (My brother died from throat cancer at age 40. Have to admit I am a bit more alterted because of this.)  Also, I have recently taken the AMAS cancer screening test.  The results were "borderline" and they suggested retaking it for confirmation.

thank you!

[Jules77733]

Wow, my heart really goes out to you. I don't know how the different cancers are linked--or if they are, at all--but it sure sounds like it could be genetic. Two people in my family have had cancer (one survived, but it's only been in remission for a year at this point), and I lost a 22-yr-old friend to a rare form of cancer a few months ago. While it doesn't appear to run strongly in my family as some kind of inherited condition, heart disease, terrible allergies, and diabetes do.

I wish the best for you, and I'll be anxious to hear how everything goes for you. I also had similar ultrasound results and labwork, though my TSH has been slightly out of range and jumping all over the place in the normal range, and my TGAb and TPOAb were both normal, though TGAb was high-normal.

[Mark Lupo, M.D.]

Sounds like Hashimoto's to me - the positive Tg-Ab and the inhomogeneous US appearance is typical for this.  TPO antbodies are negative in about 10% of hashi patients.  If there is not a nodule on thyroid ultrasound, then at this point the risk of thyroid cancer is very low.

[QueenBTeacher]

Grandmother (fraternal) - breast; Uncle, age 51 (fraternal) - lung cancer; Aunt age 50(fraternal) - breast. Father - adenocarcinoma of unknown origin. Found too late. Died w/in 2 weeks of diagnosis.  Mother - small cell lung caner (yes, a smoker), died w/in a year; Brother - squamous cell cancer - began in tonsils, spread to stage IV by the time of diagnosis (died at 40 a year after diagnosis); Sister -age 53, adenocarcinoma probably originated in lung (not a smoker) but by the time she was diagnosed it had spread to spine, etc.  
I am what they call "high risk".  Thanks for asking.  

[Jules77733]

May I ask what type(s) of cancer your other family members, besides your cousin and brother, have? I'm so sorry to hear you lost many people close to you from this disease...:(