nodule questions

[mmazzur]

I recently received my thyroid results: Assessment- Toxic multinodular goiter. Thyroid Dimensions Rt Lobe: 5.6x3.1x2.2cm Left lobe 5.4x1.3x1.3cm Isthmus 0.3cm. The echotexture of the rt lobe is severly heterogeneous and the left lobe is moderately heterogeneous. Nodule 1- Rt. lobe, entire pole 4.7x3.2x2.5 cm Nodule 2 Left lobe, upper/mid pole, 0.8x0.8x0.9cm both predominately solid. Nodule 3 Left lobe, mid pole 0.8x0.6x0.1cm solid. TSH 0.05 Free T4 1.0 T3 Free 432 T3 Toral 182. Can someone interpret these results for me. I am really scared. I have biopsy set up for thurs. Are nodules this large usually cancerous? The large nodule was hot, smaller were cold

[teacher40]

I also have a multinodular goiter.  I had an ultrasound and a biopsy done about 6 months ago.  My largest nodular was hot.  They only biopsied the larger nodule and it was benign.  My blood work is fine and I am not on any meds.  I remember that feeling of not knowing and still feel nervous about having nodules on my thyroid.  Are you on thyroid meds?  Have you had a biopsy before?  This site is great with helping you feel like you are not alone.  Most nodules are not cancerous, especially the hot nodule.  

[mmazzur]

I am on 5MG Methimazole. No biopsy before. It is very scary not knowing and the process seems so long. I feel like if it is this big it must have been growing for a long time and could have spread

[MANmom]

mmazzur, sounds like you should consider surgery.  I had four nodules, the largest was 2.1 cm, the smallest just under 1 cm...had an FNA biospy, that came back "benign follicular clusters" but NOT diagnostic for cancer.  I just had the right lobe removed hoping that the three nodules there were causing my symptoms of hoarseness and swallowing difficulties, and also hoping to be able to keep the left side in tact for thyroid function.  This time the biospy came back as follicular cancer.  The cancer was found in all the nodules, not just the large one.  I have to have the other side removed because the nodule there is big - 1.4 cm.  I would get a FNA biopsy, although like mine can be unreliable.  Then I would consider at least a lobectomy to check for cancer if you get a non-diagnosis.  If they can determine with a FNA that your are cancer free, then that should ease your mind.  My nodules were all solid, vascular, smooth and round, and my TPOab was elevated, which all pointed to a higher possibility of cancer...

[898]

Hot nodules are benign in 99% of the cases. the nodules are suspicios for cancer when they are hypoechoic, solid, show internal blood flow and microcalcification.The surgery recommendation can be made if nodules are growing rapidly; the heterogeneous echotexture suggest damage to thyroid due to inflammatory process.

[mmazzur]

The endo said she will probably suggest surgery either way because of the size. Does the biopsy hurt?

[4ur411]

I was just curious as to why they only biopsied "ONE" of your nodules.  Do they assume if one is benign, they are ALL benign?  If so, there must be something I'm missing, because this doesn't make sense to me.  Did they explain why the other nodules were not biopsied?  Thanks

[4ur411]

Dear MANmom,  I'm the one, the seemingly paranoid one who worried cancer could be over-looked.  I noticed your response to another member states that cancer was found in all nodules, when I thought your cancer was not found in the nodules, but in the thyroid tissue.  Did I mis-read your information?  Did you have cancer in both your nodules and the tissue?  If they found it in the nodules, was it located with the FNA biopsy?  Is it common to check the tissue once it is known to be in the nodules?  Just trying to get a better understanding of what I should expect my doctor to be doing.  Thanks again!  4ur411

[MANmom]

Yes, the original doctor I talked to wasn't clear on the pathology report the first time around, he was a resident, and a new one...he should have stated that my cancer was incedental to the nodules.  I found this out after I went over the report myself and questioned it later.  No cancer was found in my nodules, they were all in the thyroid tissue.