Thyroid nodule - should I worry?

[lana99]

Hi, I'm 40 year old. Had an ultrasound, that showed a single nodule 0.96x 0.72 x 0.4 in the right lobe of the thyroid gland. My blood tests are fine. The doctor said that it is most likely adenoma and nothing to worry about, just repeat the ultrasound in 6 months. Should I go to the endocrinologyst or just wait 6 months?

Thank you!

[898]

At the given moment the 6 month trial sounds reasonable; if nodule will grow over ths period the biopsy will be indicated [it is done to thenodules thatare larger then 1 cm];
you may also to have it done now, but keep in mind that 40% of 40 y.o. have small nodules in the thyroid.

[lana99]

Thank you very much for the answer. Sounds like there is nothing to worry about for now, so i'll wait 6 months. Thanks!!!!

[lana99]

Got my ultrasound report. It is saying - complex mass in the right lobe of the thyroiid 0.98 x 0.72 x 0.76, thyroid scan is recommended. Went for the scan, but don't have the report yet. What does "complex mass" mean, does it mean it is not a cyst and there is a possibility of cancer?

Thanks a lot!

[898]

Complex nodule  means it is the cyst with BOTH fluid [possibly colloid]  and some solid materail[possible fibrous tissue] mixed together. Statistically, the complex nodules are believed to have 20 % chance to be malignant, as compared to 10 % for simple cod solid nodule.
For this particular nodule [size close to 1cm and complex composition], the ultrasound guided FNA can be suggested;
If found benign,nodules like that are usually observed for size increase, using the semiannual ultrasound.

[lana99]

Thank you so much for your response!
One more question I have. I know that thyroid scan will check if it is "cold", "worm" or "hot" nodule. Do you think I have to ask for FNA even if the nodule is not "cold" or should I leave it up to my doctor?

[898]

Unless the nodule is HOT, the nodules are subject to biopsy. If it is at easy to reach location and ultrasound guidance will be available to get sample from the SOLID portion of the complex mass, for the pease of mind you can insist on biopsy; [if nodule will be 2 times smaller and only cystic or only solid, i would not mention biopsy at all].

[lana99]

Thank you very very much! Have a good Labor day weekend!

[lana99]

Hello ,
Just got my Thyroid scan and uptake results back. It sais 24 hour RAI uptake is 24% which is normal. Thyroid scan reveals normal activity whithin a normal appearing left and right thyroid lobe. A mass is not identified.

Now I'm confused. How is it possible that mass was identified on ultrasound and there is no mass on thyroid scan? Which one is more accurate? What should be my next step?

Thanks a lot!!

[898]

If mass is not visible on the scan it means the nodule is "warm';as it takes same amount of RAI as surrounding tissue; such "warm" nodules as well as "cold" [not iodine taking nodules] have equal malignancy chance.
the Hot nodules which show the INCREASED uptake compared to the rest of the gland are beningn in 99.99% of the cases

[lana99]

So, my next step should be FNA - is it right?

[898]

yes that's correct

[JLWH]

Lana, I'd not worry too much about having the biopsy done.  I've had a couple of them and they are not at all anything to panic about.  If you can stand a blood test, you can certainly handle this with ease as the needle is even finer than those used for blood tests!  

It's likely that there's not much to worry about, but better to be on the safe side for the bit of time that it would take to have it done.  And, the fact that it's a warm nodule as opposed to a cold (while as 898 has said already) means that there's more or less an equal chance of a malignancy, they do tend to be less stressed out over a warm nodule than a cold one and especially since yours is not even at the 1 cm mark.  It's just a precaution that puts everyone's minds at ease.

Best of luck and wishes!

[lana99]

898 and JLWH!
Thank you very much for your answers. Talked to my doctor, he thinks that is is better to do another ultrasound in 6 months. Can I just ask him to send me for FNA or it is up to him?

[898]

Lana, the final decision is yours, however you could wait 6 month and re-test with the ultrasound if:
The re-test will be done on the same equipment to insure the “repeatability’ [my professional term] of the measurements;
This was your first ultrasound, and no thyroid ultrasounds were done before, so the nodule could be there for several years already
You do not have increased chances for thyroid cancer [family history; living on radioiodine contaminated areas at early age, etc.
The nodule is located at the place where its’ growth can be easily spotted, such as anterior neck, not the rear pole.

[Shherry]

Hi Lana,

I'm in the same boat as you ... I have 0.8 cm nodule (complex) but both sides of my thyroid are slightly enlarged too.  I had been thinking I wanted to just get the fna and get it over with but the endo said he may not even be able to get a good sample at that size.  He did give me Synthroid though (very small dose) to see if it would shrink and do the recheck in 6 months.  I'm a worry wart though and hate to wait the 6 months but guess I don't have a choice.  Good luck!

[lana99]

Hello,
I'm back with another question. About 2-3 weeks ago I noticed a lump on the right side of my neck (same side as the thyroid nodule). But the lump is much higher than thyroid gland. Actualy it looks like the artery is a little bit swallen (it is located right on the artery). Should I worry, is it somehow related to my thyroid?

Thanks a lot!
Lana

[898]

If this lump moves up as you swallow, this can be orignated at thyroid; if lump is not moving, it can be inflammed artery wall [it should pulsate], or lymph node.
If lump is painful or getting bigger it is good idea to check it professionally.
typically the minor inflammations should not last more then few days