what does this really mean

The thyroid gland is diffusely enlarged and demonstrates heterogeneous echogenicity of the right lobe of thyroid measuring 5.4 x 2.0 x 1.6 cm. Left lobe 6.2 x 1.9 x 2.5 cm. The isthmus measures 1 cm in thickness. There is solid echogenic vascular nodules at the isthmus, 1.0 x 0.9 1.0 cm. FNAC should be performed.

[Mark Lupo, M.D.]

Slightly prominent thyroid with changes commonly seen in thyroiditis (usually due to hashimoto's).  If there is an echogenic nodule that is brighter than the surrounding thyroid tissue, in this setting, it is low risk for cancer.  Would test TPO antibodies and TSH levels to confirm thyroid status and ? Hashimoto's.