Ultrasound of Thyroid Gland

[ldykes0001]

I am writing to you for an opinion of my US.  Let me start off by saying that I have had 2 Cervical ACDF at C5-C6, C6-C7, metal plates and donor bones.  I am currently getting scheduled for my 3rd Cervical surgery for C4-C5 herniation and C3-C4 nerve entrapment.   Now with all this being said, I have had alot of cervical radiation since 2003.
On my last MRI of the Cervical Spine, which was about 2 years ago, it was noted in the Impression that I had a Small Thyroid Cyst on my RT. Thyroid.  Nothing has ever been said about it until my last MRI done about 2 months ago.  The radiologist that read the report stated a US of the Thyroid needed.  So I had one done 9-17-2014.  The report reads as follows...

Thyroid gland is within the normal range in size.  The RT Thyroid lobe measures 4 × 1.7 × 2 cm in size and the LT Thyroid lobe measures 4 × 1.1 ×1.8 cm in size.  Isthmus measures 2mm in anterior-posterior dimensions.

Within the mid right thyroid lobe, note is made of a complex,  partially solid, partially cystic appearing nodule.  This nodule measures 21 × 11 ×12 mm in size.  This nodule appears primarily cystic, however an internal septation and an eccentrically positioned solid component are identified.   There is suggestion of some blood flow within these solid components given this, consideration should be given to a biopsy of the solid portions of tbis nodule.  At a minimum, continued ultrasound follow-up would be highly recommended.

Also within the RT Thyroid  lobe, adjacent to the previously described nodule, note is made of a small  4 × 3 by 3 mm solid-appearing, hypoechoic nodule.  No additional discrete thyroid nodules are identified.

Impression:  1.  Within the mid right thyroid lobe, note is made of a 21 mm complex appearing nodule.  There is suggestion of some mild hypervascularity within the solid portions of this nodule.  Given this, consideration should be given to biopsy.  2. A tiny (4mm) right thyroid lobe nodule is also identified.   3.  No abnormal enlargement  thyroid gland is seen.

Okay, I am going into my second week with this.  My pain treatment Dr. Told me she would set up a biopsy asap.  My primary care Dr., the one who ordered this, I have heard nothing from.  I am just wondering if I might have anything to worry about.  If I have the biopsy,  it comes back positive for cancerous cells, what happens next???  Also, I have had no other test performed on me for this except for this UltraSound.  Thanks for your input and opinion in advance.

Ldykes0001

[ldykes0001]

Oh Bless you!  I am definitely going to ask to have this US performed instead of the regular biopsy.   Thank you so much for this information,  without it I would probably go through the biopsy for results.

[898_1]

http://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-7-issue-7/vol-7-issue-7-p-6-7/
THE FULL ARTICLE TITLE:
Zhang B et al. Shear wave elastography for differentiation of benign and malignant thyroid nodules: a meta-analysis. J Ultrasound Med 2013;32:2163-9.
If this method works as expected many thyroid biopsies could be avoided!

[ldykes0001]

Thank you so much for your response.  I went to your profile but did not see the new type of test for nodules to small to biopsy.  I am new, very new to this site and not sure where to look on your profile.  Any help would be much appreciated!   Thanks 898

[898_1]

Internal septation means it has few compartments (think about soap bubbles stuck together.
Eccentrically positioned solid component - this looks like finger like growth that warrants biopsy
a nodule on other side is too small for biopsy.
A chance of cancer now is bout 10%
There is anew type of ultrasound (see one of my questions at my profile) that can be used to evaluate  many nodules for cancer risk without biopsy