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4065534 tn?1400548736

Help reading nodule biopsy and ultrasound results

If anyone know what any of this means, I would greatly appreciate it. I got a copy of my results and I am trying to make sense of them. I hope I don't overwhelm anyone whit this amount of information.

Biopsy results: There were four needle passes of my largest nodule ( I have around 6) :

A- Left thyroid nodule biopsy on thin prep:
      Rare groups of follicular cells in variably-sized follicles and macrophages
B- Left thyroid nodule biopsy on FNA:
       Rare groups of follicular cells in variably-sized follicles and colloid present
C-  Left thyroid biopsy on FNA:
        Rare groups of follicular cells in variably-sized follicles
D-  Left thyroid nodule biopsy on FNA:
       Blood present
Diagnosis Comment:
There is just enough cellularity present to make adequacy. The findings are consistent with a benign thyroid nodule.

Ultrasound Report :

" The thyroid gland is overall heterogeneous. There is normal vascularity.
The isthmus measure 2mm.
The right lobe measures 6.5 x 2 x 1.3 cm it contained 2 small nodules as below.
In the mid pole, there is a cystic 3 x 2mm nodule
In the lower pole, there is a solid, hetergeneous nodule 7 x 4 mm.
The left lobe measure 5.9 x 1.9 x 1.4 cm. It contains 5 nodules as listed below.
In the upper pole, there is a 3 x 2 mm hypoechoic complex nodule.
In the mid pole, there is a 4 x 2 mm cystic nodule.
In the mid pole there is a cystic, complex nodule 6 x 3 mm.
In the mid/lower pole, there is a complex nodule containing diffuse vascularity 1.2 x 0.5 cm. It contains scattered small calcifications.
In the lower pole, there is heterogeneous, solid nodule 5 x 3 mm,

Yet i am told that the pain and swelling in my neck is nothing more than acid reflux as the nodules are too small to be felt. What?!?

Also my  extreme exhaustion and hair loss symptoms (among many other ) are  nothing. I know i need to find another doctor, currently the newer ones that were suggested to me do not take my insurance. My funds are low so paying for one is not an option either.

Thank you for taking a look. I do appreciate the feedback.


12 Responses
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4065534 tn?1400548736
Thanks barb! The body is so intricate. It takes such a while to piece it together and find what is wrong!
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
When I was really hypo, I had some shortness of breath; doubt it would cause bronchial spasms, but you never know.
Helpful - 0
4065534 tn?1400548736
ok I will keep that in mind.

Would you happen to know if thyroid issues can cause breathing issues? I was in the ER all last night from what were called "bronchial spasms" And I was given an inhaler.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
If you can't get your endo to run the FT3, there are online sites, from which you can order a thyroid panel with TSH, FT3 and FT4 for about $100. It's not covered by insurance, but often if you go into the doctor's office, with labs in hand, you get better action.
Helpful - 0
4065534 tn?1400548736
Thanks Barb. The 1.21 FT4 was prior to any treatment. It went along with the TSH that was slightly elevated.

I am trying to get a FT3 done, have been trying for months, I see my endo again this month and am going to have to demand more sternly that he do this test but his response is " Let me just do these tests first and we'll know where to go." Which of course is always no where.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
TSH varies widely, even intraday; it's a very poor indicator of thyroid health.

Was the FT4 of 1.21 prior to any medication or were you medicated at that test, as well?

TSH is often low/suppressed when one is on thyroid medication and it seems that FT4 tends to run a bit lower in those on Armour.  You have not FT3 result, so we don't know whether you simply need a higher dosage of thyroid medication, since FT3 is the active form of hormone.
Helpful - 0
4065534 tn?1400548736
Thank you for the input!


I agree with the anxiety thing. I have heard about that, and i have tried to pay attention just to be sure. I have noticed on a few occasions that I do get that lump  feeling in my neck when I am anxious. But I have been really observant about that and I have noticed when it's anxiety and when it's something more. Usually the something more neck swelling is happening when there is throbbing and aching. I don't think  my anxiety moments are causing that. I wish it were just anxiety at these moments.

Well, I don't understand how it can not be causing my symptoms. It's obviously suspicious. And i do have the family history, My grandfather was sick all his life, and results were normal. Until he got into his early 50s. Then all of a sudden the tests became very abnormal. He ended up with toxic nodule goiters and they had to kill his thyroid as well.  

I have also been to every form of  specialist for every symptom, switched my diet, went to natural doctors...homeopathic...everything for the past 8 years after falling ill at 17, after having mono twice. Nothing was found and so I was told Chronic fatigue syndrome.

i have always had this neck issue, and my mom says that when I was little my thyroid area would look swollen and puffy. then the next time she looked, it was fine.


2 months ago my TSH was 4 (range 0.450-4.00) and just a few weeks before it was .66. i found that weird. and my T4,Free(Direct) was 1.21 ng/dL Range 0.82-1.77

Currently as of July 19th : ( 6 weeks on Armour)

TSH 0.788 uIU/mL   Range 0.450-4.500

T4,Free(Direct) 0.99 ng/dL    Range 0.82-1.77

Thyrotropin Receptor Ab, Serum <0.51 Range 0.00-1.75

Thyroid Stim Immunoglobulin 26 %   Range  0-139

Antithyroglobulin Ab <20       Range 0-40

Thyroid Peroxidase (TPO) Ab 9 IU/mL 0-34

Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Most of us with Hashimoto's and/or Graves Disease have nodules and some have cysts on thyroid.  Heterogeneous simply means that the thyroid consists of dissimilar or diverse ingredients or constituents.  Normal?  No, not really, but not the least uncommon, either.

I don't doubt that your thyroid may be swollen, somewhat, but apparently, it's not pressing on anything to cause your symptoms.

I'm sorry, you've probably posted this all before, but what antibodies were you tested for and what were the actual results, with ranges?

I hate to bring this up, because most people reject it right off the bat (I didn't want to hear it either), but have you considered anxiety as a cause for the difficulty swallowing and swollen feeling, even the shooting pains? You know how, when you feel like you're going to cry, you get this huge "lump" in your throat, just before the waterfall starts?  Anxiety can be present even when one doesn't "feel" anxious, but of course, you are, because you don't feel well and you don't know why; that's a normal psychological reaction and happens to us all.  

Anxiety is a very common symptom of being hypo.  How long ago were your TSH, FT3 and FT4 tested?  If you have current results, please post them, with reference ranges.
Helpful - 0
4065534 tn?1400548736
sorry..Barb..not Barbm...these darn fingers! lol!
Helpful - 0
4065534 tn?1400548736
Thanks Barbm

I was tested for hashimotos antibodies and it came back negative.

my TSH levels , and FT4 levels have shown me to be slightly hypo.

The neck issues I have are :

I feel like my actual thyroid is swelling, and I will feel like it is throbbing.
I will have this ache and shoots of pain that feel like they come from my thyroid.  I have difficulty swallowing at times. The only thing that ever helps is ibuprofen, then the ache will go away for a few hours.

And yes, of course I am happy that it is not cancerous. That good! But I am now trying to get an explanation for my symptoms.

It can't be normal to have nodules and cyst, or a heterogeneous thyroid gland right?
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
"The findings are consistent with a benign thyroid nodule."  That's one answer.  

Your nodules are quite small and I'd agree that it's unlikely that they would be a cause of pain in your neck.  

Can you describe the pain?

Can you please refresh my memory?  Do you have Hashimoto's?  If so, the antibodies can cause inflammation which in turn can cause swelling.
Helpful - 0
4065534 tn?1400548736
Sorry forgot to add this at the bottom of the biopsy:
Gross description:
A. 10 ml of watery brown clear fluid
B. 2 smears
c. 2 smears
D. 2 smears.


Not sure if that was relevant,but thought I would add it anyway!
Helpful - 0
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