Ultrasound Results Question

[whittie1]

I'm new here but have been reading though the archives.  None really answer my questions. If any of you can be so kind as to answer I'd deeply appreciate it.  I'm a 37 y/o female.

My recent physical found to masses in my neck.  I was sent for thyroid tests and here are the results:

Ultrasound: I have a 0.8cm solid nodule on my right lobe and a 0.3cm calcification in the mid portion of my left lobe. Impression: Bilateral nodular goiter.

Labs: TSH was 4.3 (.350 - 5.5), Thyroxine (T4) was 7.0 (4.5 - 12.0), T3 Uptake was 30 (24-39), Free Thyroxine Index was 2.1 (1.2 - 4.9).  (I had thyroid labs taken yearly my whole adult life due to family history and its always been normal).

I have a family history of thyroid problems and one cousin even had thyroid cancer but I dont know which kind.  So now I'm all freaked out over it.  The ultrasound report said to wait a year and test again.  My FP agreed I supposed as I tryed to get a referral for a Endo and they have not provided it.  I did manage to speak to one Endo office who said without a referral you need to send your labs and the doctors review and decide if they will see you.  I sent the above reports and got an appt of July 16th.  I had kinda hoped that they would never call and I can convince myself I'm OK.

So, this Calcification, does that always have to mean Cancer?  I also wanted to note that I have no physical symptoms.

[shaerich]

No, calcification does not mean cancer.  I also had a calcification and it was nothing.  

As for your labs... I'm a dummy with that stuff, but there are lots of pros on here who can help you with that.

Try to relax... if the dr.'s aren't terribly concerned then there is no rush and you just have to take it as it comes.  ThyCa is rare, but it's also pretty treatable if caught early and it sounds like you're pretty diligent with having yours checked.

I'm not dismissing your fear.  I just want to try to alleviate some of your panic.

[ChitChatNine]

I think the results mean you need to be followed ev. 6mos - a year to be certain there are no changes that indicate further action.  But I'm not a Dr at all ... just a thyroid person who had surgery in January and is new to all this.

I think all will be ok and good idea to touch base with the Endo and follow thru with that Dr. for followup treatment ... they are an asset to have when dealing with this type of stuff.  I thought I'd never see mine again bcz all 11 vials of blood were normal and they were removing 1/2 the gland .. turns out two very small incidental cancer findings were in that gland and the orig. 2 nodules were totally benign.

So my relationship with the Endo contnues and this is a good thing as I got right in after the surger 1-2-3 with an appt bcz I wasn't a "new" patient!

Cheryl

[ChitChatNine]

I forgot to mention I have a 3mm nodule on the intact gland .. they follow every 6mos via ultrasound ... they tell me it is "stable" and that 3mm is considered "tiny" ...

Don't get me started on the size thing .... IMHO I don't care how big or small it is just take precautions with it.  I am surprised your FP won't give you a referral.  Try again ...... let him know if "anything" happens it is his personal responsibility and will he be able to put his head on the pillow to sleep at night?  Well, it sounds good in theory :0

C~

[whittie1]

*taking a deep breath*

Thanks, I feel somewhat better already.  

[whittie1]

Cheryl,

Mind if I ask why they were removing half of your gland in the first place?

[ChitChatNine]

Two nodules my primary doc felt on a routine exam .. they ultrasounded 1.9cm and the other was smaller .... I had a biopsy and it came back "atypical follicular cells" ............. and the pathologist said I had no choice but to have them out bcz 25% turn into cancer if left intact.  I totally agreed and had the surgery.  Unfortunately the other nodules which did not show up on ultrasound did not get found on the frozen biopsy during surgery so they stitched me back up and then the final biopsy results revealed their presence. 0.4mm and 5mm respectively.

Much to differ among Dr's as to whether in my case to take out other side or keep in ........ after 4 opinions I have decided to watch and wait and if anything looks remotely suspicous out it comes.  No lymph nodes and fully encapsulated.  they say 30% of those autopsied who die from something else have this type of incidental cancer ... so it is a very personal decision what to do when this happens.  But trust me, Cancer is Cancer and it took months for me to feel good with my decision.

This board is just AWESOME!

C~

[Marla13]

I too have nodules in a multinodular goiter. I have two nodules of significant size. I also have calcification in the right lobe. (Calcification does put you at a higher risk of cancer but can also be benign thyroid disease.) One nodule I have is 1.9cm in largest direction on the ismus(spelling?) and the second 1.7cm. I've had two biopsies so far the first ,atypical, favoring a hyperplastic nodule and ,the second benign. I'm thinking the endo will biopsy your nodule. It's a pretty simple procedure. Just a little uncomfortable while they are taking samples. As hard as it is try not to get crazy. I know.... easier said than done. Been there done that! I've decided personally to keep having the sonograms and biopsies done. I figured  for myself it was the better choice. A lot of people would rather have their thyroid out and have the piece of mind. It will all be up to you and your doctor what your treatment will be. Just keep in mind most nodules are benign.

Best of Luck,
Keep us posted,
Marla13

[Marla13]

I need to read more careful. You don't have nodules just calcification correct?
They probably will still biopsy your thyroid tissue. Sorry for the misunderstanding . I'm a little sleepy today.

Marla13

[Marla13]

I need to read more careful. You don't have nodules just calcification correct?
They probably will still biopsy your thyroid tissue. Sorry for the misunderstanding . I'm a little sleepy today.

Marla13

[Marla13]

OOPPSS I'm having a brain fart today. I misread your post. No nodules present just calcification right? They will probably still biopsy thyroid tissue.

Sorry about that confusion,
Marla13

[whittie1]

I have a nodule on my right side and a calcification on my left.  The report was not very detaild at all but the ultrasound tech by our conversation afterwards did not feel it was anything alarming.  She was a specialist of some stort too, I had to wait 2 weeks for her to be in for that ultrasound.

[redhed87]

I found my own mass in my neck which turned out to be a 2.3cm papillary cancer.  My first diagnosis was multinodular goiter with a solitary dominant nodule on the left side.  Totally textbook for cancer.  I wouldn't play with anything..............fight for what YOU want to do.  Is it too small to biopsy?  I have no history of any thyroid issues in my family.....be careful.

[ChitChatNine]

Rereading her post, it looks like it is 0.8cm which ='s 8mm's ..... 2mm's below the 1.0cm range they will usually FNA at ......If they could FNA at my small 3mm size I'd say GO DO IT TODAY!

I'd push at the VERY least for 6mos ultrasound if he still refuses to get you a referral.  

C~

[Briggy]

I don't post often but wanted to respond to your calcification finding.

I had an enlarged thyroid, had an u/s which showed "multinodular" and calificication. I didn't have any real nodules, just a bumpy thyroid, and calcified thyroid tissue.

I had a biopsy done on both the right and left lobes and all came out fine. I was diagnosed with thyroiditis. I already knew I had Hashi's and I was about 10 months post-partum, so the inflammation made total sense.

I know when you search for info on calcification, pretty much everything you find is assocated with nodules. It's nearly impossible to find info regarding just calcified thyroid tissue.

When I looked up calcification in general (not thyroid specific), it was explained that it's scarring of tissue (due to inflammation, antibody attack, etc.)

I hope this helps put you at ease!

[whittie1]

Wow, this forum is an excellent group of ladies and I deeply appreciate each and every response.  I'm going to be following along on all of you.  

Thanks much.