Thyroid Nodules - Odd Problem

[stilltired24]

Hi all,

I'm not sure if anybody remembers my posts (24 year old male with Celiac Disease), but basically what happened was:

July Ultrasound (Initial Consult with Endo Dr to check Thyroid after Celiac Diagnosis): 8mm hypoechoic nodule found on left lobe, FNA scheduled due to family history of thyroid cancer.

August Ultrasound (Prebiopsy for FNA): 8mm nodule disappeared, new 6mm hypoechoic ill defined nodule of right lobe is found...too small to biopsy.

Sept Ultrasound (This was scheduled by a different doctor, due to palpable lymph nodes in neck): 6mm nodule on right lobe has disappeared as well. No nodules found on either lobes.

Nov Ultrasound (Followup for Lymph nodes): 8mm nodule found on left lobe, 6mm found on right nodule.

These nodules are in same positions as original U/S's. How can this be? How can they disappear and then reappear? I know human error is common, but twice at different labs? I know since they didn't grow, I have nothing to worry about, but I'm just curious if others have experienced this.

Thanks!

[armywife92]

Inflamation can be a factor with size change, and also human error. I've heard that you can get two different measurments, and as long as it's not off by much, it is probably the person measuring it that doesn't get it 100% accurate. It's like measuring your hair(well not a good example but play along). You can measure 12 inches of one strand of hair in the morning, then later that night measure it again and come up with 13 inches. Your report doesn't look alarming, and the fact that it's round is another good indicator it's noting. Mine is more like oval. I have a friend who has a 2cm nodule that's shaped like a pickle and they thought it was cancer due to the shape, but it was benign. Try not to worry too much, as you know stress can bring on a whole host of health related issues.

[stilltired24]

Hi all,

I just picked up the CD of images and the report for my latest ultrasound. The report shows 2 solid nodules and a very small cyst. Instead of confusing the situation with my words, here are the reports for my last 4 ultrasounds (newest to oldest). Now they have not grown much in this short time, but it appears they have turned more round shape. I have looked at the images myself and from what I can see, the nodule should say 10mm x 7mm x 5mm as this is the measurements showing at the bottom of the US image, but she wrote 8x7x5, not sure why. I have read the images each time and they usually match up with the report, but not this time. Either way 8 or 10mm, they are not big, I'm just wondering why every month I get more. I want something done, but with my thyroid blood levels ok and negative antibodies, my doctor feels my thyroid is normal. Also, is it normal for my thyroid lobes to change sizes so frequently...if you look from July to now, they have changed a lot. Anyways, any opinions are helpful.

Nov
------
Both thyroid lobes are normal in size. The right lobe measures 5.0 x 1.2 x 1.1cm. The left lobe measures 4.8 x 1.3 x 0.7cm. There is a subtle hypoechoic solid nodule in mid right lobe measuring 7 x 6 x 5mm, and a 2mm cyst with a bright marginal echo (calcification) is seen at right lower pole. There is a hypoechoic solid nodule in mid third of the left lobe measuring 8 x 7 x 5mm. The intervening thyroid parenchyma is homogeneous in character. Compared with previous study, two nodules consistent with adenomas and a small cyst are now seen in thyroid gland.

Sept
-----
Both thyroid lobes are normal in size. The right lobe measures 5.1 x 1.7 x 1.5cm. The left lobe measures 4.4 x 1.6 x 1.0cm. The nodule demonstrated in left lobe during July ultrasound is not demonstrated today. There are no nodules or masses seen on either lobe.

Aug
-----
Right lobe of thyroid measures 4.4 x 1.7 x 2.0 cm in size. There is an ill-defined hypoechoic area in the lower pole measuring 6 x 5 x 5
mm. It does not have clear margins. This may be an early and developing
nodule but it has not become well enough defined at this point to be biopsied. Left lobe of thyroid measures 3.9 x 1.1 x 1.0 cm. It is homogeneously echogenic without evidence of any obvious nodule.

July
-----------
Right thyroid lobe is 5.0 x 1.4 x 1.5cm, left lobe is 3.7 x 1.6 x 1.0cm and isthmus is 0.3cm. The left lobe in the middle portion shows a 0.8 x 0.5cm well defined slightly hypoechoic nodule and the echo features suggest an adenoma. There are no nodules or cysts seen on the right lobe. The parenchyma elsewhere is slightly coarse.

[stilltired24]

Hi,

I have had all the ultrasounds done at the same lab, by the same tech and reviewed by the same two radiologists. The only one that was different was the pre-biopsy, which had to be done at a hospital. But I gave them the CD of images to show them where to look for the 8mm nodule. That is why is confuses me.

I agree though, it definitely sounds like they were just missed, not gone. My doctor does not see the need for a CT because it is not very accurate at picking up small nodules.

Thanks for the help everyone!

[blsdnsvd]

My surgeon ordered a CT Scan instead of a Sonogram which I am certain...will show more detailed. Maybe you should suggest this test to your doctor...  

[armywife92]

Sometimes they are soo small they can be missed. The fact that they were found AGAIN in the SAME place(s) and same size, makes me think they never dissapeared in the first place. I've had some(and cysts)come and go, so it's possible, but i think in your case it's the former. At least they don't appear to be growing.

[laura1967]

Are you having the ultrasounds done at the same place by the same tech? Also is the same radiologist reading these?  My doctor insists on reading the actual films himself.
Many doctors will want you to have every follow up ultrasound or scan done at same facility.