Aa
I finally got to see my U/S results, all nodules <1cm!
initial post was here: http://www.medhelp.org/posts/Thyroid-Disorders/Scared--Not-sure-it-even-is-thyroid-/show/2508003
Only one of the several nodules is "suspicious" - it has blood flow, possible calcifications, and is hetergenous/partially cystic, BUT, at the time of the ultrasound it was only 6x6x4 mm, far too small for FNA. The largest measures just 7x5x3 mm, that is a nodule "hypoechoic nodular foci without fatty hila, blood flow or calcification". There a LOT of those, not just in the thyroid, but in "zone IV, inferior, left and right". If I googled correctly, because there is no hila or blood flow, they can't be lymph nodes, right?
Also, even though it's the right side that is more tender, both sides of the thyroid were roughly the same size.
The right thyroid lobe measures 1.9x2.4x3.7 cm.
The left thyroid lobe measures 1.7x2.2x4.7 cm.
The thyroid isthmus measures 3 mm AP diameter.
Anyway, I still have to wait to see an endo.
Only one of the several nodules is "suspicious" - it has blood flow, possible calcifications, and is hetergenous/partially cystic, BUT, at the time of the ultrasound it was only 6x6x4 mm, far too small for FNA. The largest measures just 7x5x3 mm, that is a nodule "hypoechoic nodular foci without fatty hila, blood flow or calcification". There a LOT of those, not just in the thyroid, but in "zone IV, inferior, left and right". If I googled correctly, because there is no hila or blood flow, they can't be lymph nodes, right?
Also, even though it's the right side that is more tender, both sides of the thyroid were roughly the same size.
The right thyroid lobe measures 1.9x2.4x3.7 cm.
The left thyroid lobe measures 1.7x2.2x4.7 cm.
The thyroid isthmus measures 3 mm AP diameter.
Anyway, I still have to wait to see an endo.
If your antibodies are within the range you may have self-limiting sub-acute thyroidits (that often follows the respiratory infection)
Thanks!
This is all so new and confusing to me, I really feel like I need hand-holding through it all.
So hypoechoic are (slightly) more likely to be malignant, but I shouldn't worry too much, because I'm hyperthyroid, and most maligancies are not toxic, if I've been reading right?
But this *could* be inflammation, you said.
My Thyroperoxidase and thyroglubulin ab's both came back well under the range for negative/normal, so what else would need to be tested?
If you can't tell, I'm super anxious about all of this. I want to blame it on the hyper, but I think it's how I am anyway :)
This is all so new and confusing to me, I really feel like I need hand-holding through it all.
So hypoechoic are (slightly) more likely to be malignant, but I shouldn't worry too much, because I'm hyperthyroid, and most maligancies are not toxic, if I've been reading right?
But this *could* be inflammation, you said.
My Thyroperoxidase and thyroglubulin ab's both came back well under the range for negative/normal, so what else would need to be tested?
If you can't tell, I'm super anxious about all of this. I want to blame it on the hyper, but I think it's how I am anyway :)
This one sounds more clear; the description sounds similar to inflammatory process involving lymph nodes in addition to thyroid. The hypoechoic areas can be actually inflamed areas (inflamed tissue has higher blood flow rate thus causing lower echo
I think I was trying too hard to summarize the report, and *I* messed that part up (oops!) Let me copy/paste the report parts here:
FINDINGS:
The thyroid gland is diffusely heterogeneous with patchy areas of slightly increased blood flow. The thyroid isthmus measures 3 mm AP diameter.
The right thyroid lobe measures 1.9x2.4x3.7 cm. In the inferior right lobe is a 6x6x4 mm heterogeneous, partially cystic nodule with blood flow in the solid components and with a tiny echogenic focus suspicious for microcalcifications.
The left thyroid lobe measures 1.7x2.2x4.7 cm. No discrete nodules are identified in the left lobe.
In right zone VI inferiorly are 3 small nodular foci without fatty hila, calcifications or blood flow, the largest of which measures 6x5x4 mm.
In left zone VI inferiorly are 3 hypoechoic nodular foci without fatty hila, blood flow or calcification, the largest measuring 7x5x3 mm.
In the sternal notch is a 4x4x3 mm hypoechoic nodular focus without a fatty hilum, significant blood flow or calcification.
Scattered normal-appearing neck nodes with distinct fatty hila are identified bilaterally.
IMPRESSION:
1. Diffusely heterogeneous thyroid gland with patchy blood flow suggest the possibility of thyroiditis.
2. 6 mm right lobe nodule has a small cystic component a small amount of blood flow and may have a microcalcification placing it at a slightly higher risk for malignancy.. This is too small to sample and continued ultrasound surveillance is recommended.
3. Subcentimeter nodular foci in the right zone VI, left zone VI and in the sternal notch could represent tiny nodes without visible fatty hila versus nodules. These have no suspicious features. Continued ultrasound surveillance is recommended
FINDINGS:
The thyroid gland is diffusely heterogeneous with patchy areas of slightly increased blood flow. The thyroid isthmus measures 3 mm AP diameter.
The right thyroid lobe measures 1.9x2.4x3.7 cm. In the inferior right lobe is a 6x6x4 mm heterogeneous, partially cystic nodule with blood flow in the solid components and with a tiny echogenic focus suspicious for microcalcifications.
The left thyroid lobe measures 1.7x2.2x4.7 cm. No discrete nodules are identified in the left lobe.
In right zone VI inferiorly are 3 small nodular foci without fatty hila, calcifications or blood flow, the largest of which measures 6x5x4 mm.
In left zone VI inferiorly are 3 hypoechoic nodular foci without fatty hila, blood flow or calcification, the largest measuring 7x5x3 mm.
In the sternal notch is a 4x4x3 mm hypoechoic nodular focus without a fatty hilum, significant blood flow or calcification.
Scattered normal-appearing neck nodes with distinct fatty hila are identified bilaterally.
IMPRESSION:
1. Diffusely heterogeneous thyroid gland with patchy blood flow suggest the possibility of thyroiditis.
2. 6 mm right lobe nodule has a small cystic component a small amount of blood flow and may have a microcalcification placing it at a slightly higher risk for malignancy.. This is too small to sample and continued ultrasound surveillance is recommended.
3. Subcentimeter nodular foci in the right zone VI, left zone VI and in the sternal notch could represent tiny nodes without visible fatty hila versus nodules. These have no suspicious features. Continued ultrasound surveillance is recommended
For for lymph node location, check this picture:
http://epomedicine.com/wp-content/uploads/2014/05/Neck-zones.jpg
The lymph node has a central area which is called as hilum. This is fatty in appearance in normal lymph node. In abnormal lymph nodes this fatty appearance is changed. Thyroid nodules however do not have a fatty hila; they usually composed from follicular cells and colloid
Based on the description of your report it looks like there is a mix-up between lymph nodes and thyroid nodule.
Therefore I would suggest to have your images evaluate by different radiologist.
A more tender lobe is not necessary larger but it is firmer if inflamed
http://epomedicine.com/wp-content/uploads/2014/05/Neck-zones.jpg
The lymph node has a central area which is called as hilum. This is fatty in appearance in normal lymph node. In abnormal lymph nodes this fatty appearance is changed. Thyroid nodules however do not have a fatty hila; they usually composed from follicular cells and colloid
Based on the description of your report it looks like there is a mix-up between lymph nodes and thyroid nodule.
Therefore I would suggest to have your images evaluate by different radiologist.
A more tender lobe is not necessary larger but it is firmer if inflamed
Wait...I've been reading more and I'm feeling less confident now.
I was thinking small = GOOD!
but now I'm wondering - could that ONE nodule in the right lobe be considered "complex"?
and the others, in "zone IV"? are those maybe just misidentified lymph nodes since they aren't *in* the thyroid?
Is it worth asking if I should have a followup u/s at some point?
I was thinking small = GOOD!
but now I'm wondering - could that ONE nodule in the right lobe be considered "complex"?
and the others, in "zone IV"? are those maybe just misidentified lymph nodes since they aren't *in* the thyroid?
Is it worth asking if I should have a followup u/s at some point?
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