US Results: What do they mean

[Samedis]

Swollen thyroid found in routine gyn. Exam.
History: TSH 9.65,  54 yr. woman, weight gain and extreme fatigue. Daughter has Hashimoto's , sister had papillary thyroid cancer.
US Findings: Scan of the thyroid gland show the right lobe to measure 4.7 x 1.6 x 1.9 and the left lobe 4.3 x 1.8 x 1.8 cm.  The gland is diffusely heterogeneous in echotexture. There are at least three more distinct nodules, in the lower pole of the right lobe measuring   6 x4 x 4 mm and 9 x 8 x 9 mm and in the upper portion of the left lobe measuring 12 x 7 x 8 mm the latter being hyperechoic. There is no adjacent adenopathy or other abnormalities identified.
IMPRESSION: Mildly enlarged thyroid gland with multiple bilateral nodules. The sonographic features are most consistent with a multinodular goiter.  I would however, recommend a follow up ultrasound to confirm stability.  These nodules would also be amenable to fine needle aspiration as clinically warranted.
Please help me understand what is being said here.
1.  Should I be concerned that the gland is diffusely heterogeneous in echotexture?
2.  Or that one of the nodules is hyperechoic?
3.  When follow ups are recommended does any change that might be detected indicate something bad?
4.  Ideally should there be absolutely no change?
5.  Does any of this sound alarming to you?
Thank you.

[kitcurious]

You are welcome. I think that question is best answered by a thyroid specialist. People do sometimes have growth of nodules, even ones that are benign, and it can become uncomfortable if the growth makes breathing or swallowing more difficult. If antibody testing supports a Hashimoto diagnosis the antibodies will probably further destroy the thyroid.

If you can, try to paste the question on the doctor's forum, you will then get a professional opinion.

[Samedis]

Should I expect these nodules to change over time? Thanks for taking the time to answer.

[kitcurious]

No, it is about the same as mine. Looks like you have Hashis. I think they all say follow-up when there are nodules present and it is standard to have a nodule greater than 1 cm in size undergo FNA.  An endocrinologst who specializes in thyroid can look at your thyroid on US and have a better idea of whether or not they really are solid nodules, what their real size is if they are, and whether to do FNA at this time. In Hashis there are frequently pseudo-nodules that are really just  part  of the "Swiss cheese" effect of the disease working on the gland
If they are able to biopsied you should have that done. 95% are benign.