With this history, the large nodule could well be "hot" - this would explain the low TSH (indicating hyperthyroidism). The FNA result of follicular neoplasm is often seen in hot nodules -- these, however, are almost never cancer. If the nodule is not "hot" then it needs to be removed as 20% of warm or cold follicular neoplasms are cancer.
An I-123 nuclear medicine uptake/scan will determine if this is hot, warm or cold.
Assuming this is a hot nodule,the best treatment options are surgery or I-131. The TSH can be normalized with methimazole (carbimazole in AZ I believe) but this is a medication with several side effects that we typically don't like to use long-term (which would usually be what is needed with a hot/toxic nodule).
This pixie is new to this stuff and seeking some explanations...
I am a 38yo girl pixie - living in NZ
a couple of months ago I went to the doctor seeking help for the nasty headaches I get that are becoming more frequent. The doc noticed a lump on my thyroid - sent me off for bloods and an ultrasound scan... Since then I have seen 2 specialists and had 2 more blood tests - results below:
Free thyroxine 7.7 (9.0-19.0) Low
TSH 0.43 (0.35-4.90)
Free Thyroxine 8.7 (9.0-19.0) Low
TSH .015 (0.35-4.90) Low
T3 6.35 (2.6-6.00) High
Free Thyroxine 13.7 (9.0-19.0)
TSH .01 (0.35-4.90) Low
T3 7.97 (2.6-6.00) High
Findings: the right lobe of the thyroid appears normal. In the left lobe there is a solitary nodule measuring 29x28x41mm which is part solid part cystic. Other than the size there are no worrying features.
Macro: 10mls of slightly cloudy blue fluid submitted together with three AF and two AD smears.
Cyto: The aspirate is cellular and consists of numerous clusters of follicular cells, some of which show microfollicular arrangement. The background consists of blood and colloid. There is no papillary differentiation identified. The cellularity of the smear and the presence of microfollicular arrangements of follicular cells raises the possibility of follicular neoplasm.
Symptoms I have noticed...
tiredness, overheating, heart flutters, muscular weakness and cramps, nervousness, inability to focus for long, soreness around the other glands in my body - eg further up neck and under arms, and of course the nasty headaches that sent me to the doc in the first place...
So - there are a lot of big words i dont understand - the docs seem to tell me I'm weird and bloods shouldnt look like that. And that half my thyroid is "suspicious" so they want to hack it out :(
The blood tests seem to indicate that my TSH is in danger of becoming extinct.
Will the removal of half my thyroid help? Are there any other options? Any that DONT include nuking me with radioactive iodine?
I'm feeling worse and worse - should i have been put on some sort of medication already?
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.