Nodule Ultrasound

[Carolinagrace]

I recently had an ultrasound of my thyroid after feeling a lump on the right side of my neck.  The ultrasound report is below.  There is a history of Thyroid Cancer in my family.

"The right lobe of the thyroid gland is enlarged measuring 4.9 cm in the craniocaudad dimension by 1.9 cm in AP dimension by 2.6 cm in transverse dimension. There is a large, slightly hypoechoic mass in the mid portion of the right lobe of the thyroid gland. This measures 3.3 x 1.5 cm. This demonstrates hyperemia. No other masses are identified in the right lobe of the thyroid gland. "
A biopsy was preformed, the pathology report showed "No malignancy" but "scant cellularity".  Endo recommends rebiopsy in 2 months, but not surgical removal.  Is this a typical course of action and what criteria would increase recommendations for surgical removal?

Thank you!

[898_1]

Hypoechoic masses are associated with internal blood flow.

[Barb135]

What was the actual result of your TSH?  Have you had other thyroid blood work done?  If so, what were the results, along with the reference ranges, which vary from lab to lab, therefore must come from your own lab report.

Have you had any antibody testing done?  It's very common for people to have an autoimmune thyroid disease and not have symptoms until the antibodies have destroyed enough of the thyroid so it no longer produces adequate hormone. It's also very common for people with Hashimoto's to have thyroid nodules. I have several of them, but they have maintained their size and shape since discovery 2 yrs ago.

[Carolinagrace]

Thank you, I was told the "mass/tumor" you see on the ultrasound is a nodule.  3.3cm X 1.5cm.  One large nodule in the thyroid gland.  I was trying to figure out how to post this question on the Expert page for the doctor but can't seem to find the button to post a comment.

Thanks

[ThyroidHunter]

Carolinagrace, I'm not competent or qualified enough to really comment on the ultrasound images. My own look quite a bit different, mine have numerous "mounds" on my gland called "nodules", a hypoechoic mass is sometimes the beginning of a tumor, sometimes means nothing, and sometimes will become a nodule. My tumors are much more distinct, and the cyst at the isthmus is very noticeable. Your gland appears, to an uneducated eye like mine, to look pretty good, especially in comparison.

With little to no symptoms, let's forget about surgery for awhile, and consider an exercise plan, healthy diet, and maybe some tests checking our vitamin and mineral health in a simple blood panel. Also, try not to stress, (although it's tough) about a family history involving an organ. Because some family members have had cancer is not a proven reason you will. However, constant ultrasounds should be maintained every 6 months at minimum I would guess. Your doc can get a clue if something heads toward cancer with a CBC which usually  would show changes in your white and red blood cells if cancer is devloping, and the fine needle shows your doc is proactive in treatment.

Best of Health, very glad I could help a bit.

[Carolinagrace]

Thank you for the response and information.  I uploaded to ultrasound images from the scan to my profile if you are interested in taking a look.  The biopsy performed was a fine needle biopsy.  I have not had many of the typical symptoms associated with thyroid disorder.  TSH levels are in the normal range.  Occassionally feel fatigue, slight chest pressure probably more associated with stress and anxiety, but would say nothing out of the oridinary.

Thanks!

[ThyroidHunter]

I have never heard of "Hyperemia" being conincident with an enlarged thyroid gland. An excellent article on hyperemia is found here: http://www.wisegeek.com/what-is-hyperemia.htm

The radiologist or physician who read your ultrasound should be questioned as to the diagnosis of blood massing in the gland. Many on this board have extensive experience with thyroid issues, and they can offer their thoughts on this.

How was the biopsy performed, by fine needle or surgically? It would also be interesting to hear if you have any unusual symptoms other than feeling the mass in your throat?

I would agree with the endo in not scheduling surgery, especially if your only symptom is noticing the mass. Some, but not all of the criteria that would increase a recommendation for surgery would include thyroid disorder symptoms that range from anxiety, to depression, skin disorders, vitamin deficiencies, and of cours, a positive biopsy as well as an increased pace of growth of the gland. There are other critieria your endo can elaborate on as well.

Hope this helps and best to you in your health.

[Carolinagrace]

Also, TSH levels are normal.  I am 30 year old mother of two in good health.