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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Nodule or lymph node?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Nodule or lymph node?
by running_man, May 04, 2007 12:00AM
Hi,
I'm a 41 year old male.
Recently found to have what my endo termed "subclinical hypothyroidism". Taking 75mcg Levothyroxine for about 6 weeks now.
original labs:
TBG 11.9 Low (12.7-25.1 mcg/mL)
Anti-TPO <10 (<35 IU/mL)
Thyroglobulin ABS 39 High (<20 IU/mL)
Thyroglobulin 44.9 High (2.0-35.0 ng/mL)
T3, Free 364 (230-420 pg/dL)
TSH 6.52 High (0.4-5.5 mIU/L)
Thyroxine, Free 1.34 (0.8-1.8 ng/dL)
I recently had an attempted biopsy of the smaller thyroid nodule but my endo couldn't seem to stick it. It is pretty small 9.3 x 4.5 x 6.5 mm. My first ultrasound showed what they thought might be a second nodule or lymph node sized 6.5 x 7.2 x 9.1 mm. My endo did an ultrasound in her office and thought this second nodule might actually be a lymph node. She didn't think it was attached to the thyroid.
So for now we are in a wait and see on the smaller nodule. She is going to have me do labs on my parathyroid as well as calcium levels. I think she said if things looked abnormal with those labs, she may want to try and biopsy the larger lymph node/nodule on a follow up visit.
Is it unusual for lymph nodes to be close to the thyroid and seen as a possible nodule? I'm not clear on what we might be looking for with the parathyroid labs.
By the way, this is really a great service and we really appreciate your feedabck.
Thanks.
I'm a 41 year old male.
Recently found to have what my endo termed "subclinical hypothyroidism". Taking 75mcg Levothyroxine for about 6 weeks now.
original labs:
TBG 11.9 Low (12.7-25.1 mcg/mL)
Anti-TPO <10 (<35 IU/mL)
Thyroglobulin ABS 39 High (<20 IU/mL)
Thyroglobulin 44.9 High (2.0-35.0 ng/mL)
T3, Free 364 (230-420 pg/dL)
TSH 6.52 High (0.4-5.5 mIU/L)
Thyroxine, Free 1.34 (0.8-1.8 ng/dL)
I recently had an attempted biopsy of the smaller thyroid nodule but my endo couldn't seem to stick it. It is pretty small 9.3 x 4.5 x 6.5 mm. My first ultrasound showed what they thought might be a second nodule or lymph node sized 6.5 x 7.2 x 9.1 mm. My endo did an ultrasound in her office and thought this second nodule might actually be a lymph node. She didn't think it was attached to the thyroid.
So for now we are in a wait and see on the smaller nodule. She is going to have me do labs on my parathyroid as well as calcium levels. I think she said if things looked abnormal with those labs, she may want to try and biopsy the larger lymph node/nodule on a follow up visit.
Is it unusual for lymph nodes to be close to the thyroid and seen as a possible nodule? I'm not clear on what we might be looking for with the parathyroid labs.
By the way, this is really a great service and we really appreciate your feedabck.
Thanks.
Doctor's Answer
by Mark Lupo, M.D., May 06, 2007 12:00AM
, May 06, 2007 12:00AM
the 'lymph node' is probably just below the thyroid (in the paratrachael node chain) - with the high Tg Ab and subclinical hypo, this is likely hashimotos - in which case this is a reactive lymph node due to inflammation within the thyroid -- usually no need to FNA these. Sometimes a parathyroid gland can look like athat as well - hence the Ca check.
