Hashimotos and nodules

[Srishti]

Is it common to have nodules with Hashimoto's? I was recently diagnosed with a nodule that came suspicious in biopsy done by ENT doctor. I went to an endo to get a second opinion and he diagnosed me with Hashimotos because of antibodies in blood. He does not think that I need to repeat FNA or go through surgery. Should I get a third opinion?

[Srishti]

Thanks 898. I saw another endo today who is sending me to a radiologist who will do US guided biopsy and they also send the labs to one of the best cyto labs in my area. I feel more comfortable now.

[898]

The correct procedure for nodule evaluation of the thyroid is as follows:
a]ultrasound is done to determine size, borders, type[solid complex or cystic] and number of nodules.
b]Any nodule with increased vascularity or complex must undergo biopsy WITH ultrasound to take sample from the right place;
c] if the suspicios biopsy from the nodule with irregular borders surgery may be a good choice.
Jumping such steps may cause unnecessary surgery or may miss the early signs of malignacy where complete thyroid removal would be necessary.
Conclusion: get someone else look on your nodule.
The decision for treatment is mainly based on the patient's 'vote' and doctor's recommendation. There is no excuse to skip diagnostic steps or make them using 28-years ago approach.

[Srishti]

Thanks 898. The endo to whom I went for 2nd opinion did some blood tests and does not think we need to repeat FNA. FNA came suspicious but it was not done with ultrasound guidance nor was sent to a cystologist. I am just wondering if should go for a 3rd opinion or I can trust the 2nd opinion guy and breathe easy?

[898]

The long standing [and unnoticed] Hashimoto's disease leads to nodule formation.
I would suggest the experienced pathologist to review the biopsy report.