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Concerned about ultrasound results of thyroid

I received my ultrasound results yesterday for my thyroid. The Dr told me that I needed a FNA to see if the mass is malignant or benign. He wasn't very informative, so I asked the nurse if I could have a copy of the results to which I was denied. I took it upon myself this morning to go to the hospital and pick up the information. I now have the paperwork and need to know if someone can help me figure out if this is bad or not? I heard hypoechoic mass can be malignant and after doing hours of research on the internet, I think I've scared myself more than I was when I first received the news. I suffer from anxiety and it's only getting worse with me trying to (silly) decipher what all of this means.

THYROID/NECK ULTRASOUND.
INDICATIONS: Enlarged thyroid
COMPARISON: No priors
TECHNIQUE: Routine ultrasound performed for the thyroid gland
FINDINGS: The gland appears prominent. The right lobe measures 4.2 x 1.7 x
1.8 cm. The left lobe measures 4.6 x 1.5 x 1.8 cm. The isthmus measures
3.4 mm. There is somewhat heterogeneous echotexture of the gland. In the
right lobe there are no definite focal abnormalities. In the left lobe
there is a slightly hypoechoic nodular structure of 1.8 x 0.8 x 1.5 cm.
This shows increased vascularity. There are no abnormal calcifications.
Concerning this lesion recommend also correlation with nuclear medicine
thyroid scan and uptake studies prior to decision for further followup
versus fine-needle aspiration biopsy. In the remainder of the thyroid
gland no obvious nodular lesions. Outside the gland no abnormalities are
seen.

IMPRESSION1. Prominent size of the gland with somewhat heterogeneous
texture.2. In the left lobe close to the upper pole there is an
oval-shaped slightly hypoechoic structure of about 1.8 x 0.8 x 1.5 cm
which shows increased internal vascularity. Concerning this lesion
recommend also correlation with nuclear medicine thyroid scan and uptake
studies prior to decision for followup or fine needle aspiration biopsy.
CPT: 76536. Ultrasound of the soft tissues of the head or neck.
3 Responses
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Avatar universal
Hyperemic means it has increased blood flow; hypoechoic means that its tissue reflects less waves than neighboring tissue.
I would recommend trying to get shear wave ultrasound which will make better justification if biopsy is needed
Helpful - 0
Avatar universal
Thanks for the reply! I was browsing through the information I got back from the hospital and it seems that there is two different reports? Radiologists report states what I pasted above, then I have another report that states the complete opposite?

Heterogenous, well circumscribed markedly hyperemic lesion upper pole left thyroid. Remainder of thyroid appears WNL.

As fas as I knew, hyperemic and hypoechoic are two different things. Would it be recommended to have another ultrasound done to make sure, or continue on with the FNA? My Dr. is adamant on getting it done, but it won't be until the 28th.
Helpful - 0
Avatar universal
Right lobe measures 4.2 x 1.7 x
1.8 cm
The volume is approx 6.2 ml
The left lobe measures 4.6 x 1.5 x 1.8 cm
The volume is approx 6.0 ml
Total volume is 12.2 which is larger than average 7.3 ml, but still less than 18 ml (upper limit per WHO)
isthmus measures 3.4 mm.(common 2.3)
In the left lobe
There is a slightly hypoechoic nodular structure of 1.8 x 0.8 x 1.5 cm.
This shows increased vascularity. There are no abnormal calcifications.
I would recommend looking on it under high resolution's shear  wave ultrasound because his feature may be so-called pseudo nodule, before sticking needle into it.
There is no information of borders surrounding such nodule so it is hard to say if it is adenoma or something else.
It is indirectly stated in the report that lymph nodes are appear normal which is good.
The nuclear scan will not provide additional information unless your TSH is low and you are not taking Metformin.


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