Scary nodule size? My GP won't tell me

[canadagoose10]

I'm anxiously awaiting a referral and FNA from an Endo, and it's taking forever for them to call me.  2 weeks so far, and no appt is set.  My GP wouldn't discuss my test results, only telling me to wait patiently  until after my biopsy.  The problem is, it could be 6-8 MONTHS before I get in to see the Endo (Canada ***** for waitlists).

Please Dr Lupo, give me your impression of my results from ultrasound on Feb 27th.  Word for word report:

History: Increased right lobe

Findings:
The right lobe is mildly increased in size compared with the left with the right lobe measuring 55 x 22 x 30 mm and left lobe 58 x 15x 19 mm.  There is a dominant complex cystic and solid mass in the mid-lower pole of right lobe measuring 37 x 17 x 30 mm.  The has prominent vascularity associated with it.  The right lobe of the thyroid is otherwise heterogeneous in appearance with no discrete smaller nodules identified.  On the left there are multiple small hypoechoic nodules present.  The largest posteriorly and inferiorly measures 10 x 7 x 6 mm with multiple other smaller nodules measuring 6mm or less in size.  The isthmus measures 4mm with no focal abnormalities.

Impression:

Bilateral thyroid nodules.  The dominant nodule in the lower right lobe is 3.7 x 1.7 x 3.0 cm.

-----------------------------------------------------------------
My biggest worry is I'm having compression symptoms, and all over body swelling and some pain.  My GP basically brushed that off.  Can you please give me some honest feedback? I'm able to deal with anything as long as I have information.  Thanks so much

[898_1]

When ultrasound alone fails to give clear picture of what is going on, a second imaging test is requred. Then both tests are reviewd at the same time by the radiologist:)

[canadagoose10]

She's ordered one, the problem is it's not done in her office, so I have to wait for an appointment with a different specialist.  She said the surgeon can probably do it when I see him May 2nd, but if not, it might just be done as pathology after surgery.  She doesn't want me waiting months on end to have the testing, and on average its' 3 months for an US guided FNA.

[Jill62]

I am surprised that with a fine needle biopsy has not been done. It's the best way to find out if it's benign, although in some cases it comes out inconclusive but that's what I would ask for.
My endo. said if any of my nodules grows over 1cm (10mm), she'll order the biopsy.

[moonlight0]

Ultrasound with fine nidle gaided punction has precedence in thyroid examination (because of better rezolution, nodules size of 2mm can be detected). CT is not  indicated at all.

[898_1]

The next step could be the CT scan with contrast (this will show better then the ultrasound if blood fills the nodule or something else).the ruptured blood vessel produces cyst which usually collapses (gets smaller after few days).
The rupture of the blood vessel (internal bleeding) is treated by applying cold to the area to reduce blood flow, avoiding stressing the neck and not taking drugs containing blood thinners such as aspirin. The injection of calcium chloride was commonly used in the past to treat internal bleeding. The infection or inflammation will cause pain fever and hardening of the nodule rather then ballooning of it.

[moonlight0]

I must agree it is not attractive, but most immportantly that it is not malignant. Annyway,  you have not to be afraid, therapy options are good, just it is not comfortable waiting findings

[canadagoose10]

she said it could be due to cystic fluid or bleeding inside the nodule.  Either way, it's not attractive and it frightens me :(

[blsdnsvd]

From my experience, you will be told to remove your entire thyroid due to the size alone.

[moonlight0]

Maybe your nodule is growing due to  fluid load in cystic part of nodule, but it certanly must be proved by biopsy.Nodules of that sizes ussualy do not cause compression syndrom, but it must be verify by fluoroscopy of the trachea

[canadagoose10]

'The Endo used some ruler type thing.  Plus she said she could tell by look/feel it was much larger than the US stated.  It's far more visible now than it was even a month ago.  The plus side is I was notified of a surgeon consultation the first week of May.  I'll probably have the thyroid removed before a biopsy.. *sadly*.  Now more waiting.

[Barb135]

I'm very sorry that you didn't get the biopsy. Did you have another ultra sound that showed the nodule is growing?

I've sent a PM to one of our members who is very good at interpreting ultra sound results.  Hopefully, he will chime in and give you an idea of what might be going on.

[canadagoose10]

Update:  the scheduled biopsy wasn't apparently on the books.  My GP was wrong in her thinking the Endo would do it today in her office.  I actually have to wait on another referral to a pathologist for that.  Could be 2-3 months before it happens.  And the nodule is now 5cm+.  I knew it was growing, but am still shocked at how much.  It doesn't matter one whit to the doctor though.  She can't change the waits, so I have to somehow find a way to pass the time without causing myself a stroke.  

[ChitChatNine]

Please keep us posted ... I had an FNA in 2006 and it wasn't too bad.

Here is a link to our Ask a Radiologist expert forum which is free:
http://www.medhelp.org/forums/Radiology/show/909

Maybe you can post your question there as you wait!

C~

[canadagoose10]

Update:

After a few phone calls to the specialists office and my GP, I now have an appointment scheduled on Mar 28th.  I'm relieved and a bit worried at the same time.  Considering I was quoted 3-6 months minimum to get in, and they've got me there in 2 weeks instead? ...

Any feedback from the forum? Please help me understand what i'm possibly looking at.

[canadagoose10]

Possibly, but that depends on whether they consider it an emergency.  My own family doctor didn't even consider it urgent to give me the results :(.  I waited 10 days to see that report, and she had had it since the day of my US.  I see my Derm today, who I'm hoping will intervene and make some calls.  

[Barb135]

we have a  member who is very good at interpreting ultra sound results; maybe he will see your post and respond.  

I understand the waiting lists in Canada, but if something is an emergency, won't they get you in sooner?

[canadagoose10]

Oh ok thank you.  I only just joined after browsing the forums and hoped to get a response from well, anyone :).  I'm not sure how to navigate this site yet.

I suppose a few others will chime in? From reading, some of the members seem very wise on these matters.

[gimel]

This is the Forum for Thyroid Patients.  Dr. Lupo is on the Doctor's forum.  Sometimes when their quota of questions is full for the day, posts like your end up here.  You will have to try again to post it on the other Forum for Dr. Lupo.