Please translate and explain...

[Myam]

13/03/2010
Thyroid Ultrasonography
-The thyroid gland is of normal size, homogeneous echopattern, with smooth outline.
-The left lobe shows a small hypoechoic nodule 4mm
-The gland moves freely with deglutition
--No retrosternal extention detected.
-The trachea is centralized.
-Both carotid
sheaths are free.
-Bilateral enlarged non specific upper deep cervical and submandibular lymph nodes detected.

Conclusion:
-Bilateral enlarged non specific cervical LNs.
-Small left thyroid nodule.


27/03/2010
Tc-Pertechnetate Thyroid Scan

Clinical data:
-41 year old female patient with neck swelling

Techique:
-Spot views of the neck were aquired 20 min after injection of 5mCi of the tracer.

Findings:
-The thyroid glance is average sized with no retrosternal extention.
-It exhibits rather uniform tracer uptake pattern with no sizeable thyroid nodules detected.

N.B:
Small nodules around 1cm can be missed on scintigraphy and better resolved by neck US.

Thyroid uptake: 0.5%

Impression:
-Scintigraphically average sized diffuse thyroid gland.
-Low normal thyroid uptake for correlation with recent thyroid hormonal profile.

20/10/2010
Thyroid Songraphy

-Thyroid gland is of average size yet it apaers of heterogeneous echopattern, a small well-defined hypoechoic nodule is seen in

the left thyroid lobe measuring about 5 x 3 x 6.7mm.
-no retro-sternal extention
-intact vascular neck structure
-no cervical lymphadenopathy

Conclusion:
-Heterogenous thyroid parenchyma with left thyroid lobe nodule?? thyroiditis for thyroid function test assesment.

[Myam]

Thanks fot the answer.
I had a FNA done:
24.10.2010
Gross: Thyroid FNA left side
Micro: Films revealed excess colloid scattered red cells, few follicular cells with regular nuclei, very few lymphocytes. No nuclear anaplasia.
Diagnosis: Thyroid FNA: Follicular lesion, recent hemorrhage.

20.3.2010
TSH 2.23 ,  Serum Total T4  7.8 , Serum Total T3  109

21.10.2010 after taking Eltroxin 50mg every other day
TSH 2.23     Free T4  1.0

The doctor wants to see me again in 3 month with another TSH, T4 test and an U/S

So do I not need to worry about the nodule? Do I have thyroiditis?

[Mark Lupo, M.D.]

The low uptake on the nuclear study would suggest thyroiditis in the past - would need to correlate with TSH and thyroid antibodies.
The small nodule in the left can be observed with ultrasound (would not need more nuclear scanning for this) at 6-12 month intervals.