ultrasound shows large nodue, labs are normal

[katesnap]

hello, i'd like to post my u/s results and lab results for opinions on what all this means.  i have a biopsy scheduled for tomorrow.  i am experiencing a lot of pressure and choking feeling in my neck.   thank you so much. i am 29 and female and otherwise healthy.

report:

Examination: Thyroid Ultrasound
Indication: Thyromegaly
Impression:
1. Bilateral solid nodules right greater than left.
2. Ultrasound-guided fine needle aspiration of the dominant nodule 3.5 cm in diameter in the right lobe of the thyroid gland is reccommended.

Comparison: None
Techniquie: High Resolution ultrasound was performed with a linear array transducer. Color Doppler imaging was also performed.

Findings: The right lobe measures 4.4 x 2.7 x 2.6 cm in size. The left lobe measures 4.4 x 1.3 x 1.2 cm in size. The isthmus measures 3mm in thickness,

In the midportion of the right lobe, there is a mixed cyctic and solid lesion approximately 3.5 x 2.6 x 2.4 cm in size. The margins appear well-defined. There is central increased color Doppler signal and increased Peripheral color Doppler signal. However, no significant decrease in echogenicity of the solid components is seen. No microcalifications are suggested.

A small cyct is seen in the midportion of the left lobe 2.7cm in greatest diameter. In the upper pole of the left lobe there is a hypochoic lesions 1.0 x 0.9 cm in size with lobulated margins. No microcalifications or increased color Doppler signal are identified.



T4 free .88 (normal range 0.76 - 1.76)
TSH 1.887 (normal range 0.350 - 5.500)
T3 free 2.88 (normal range 2.3 - 4.2)

[katesnap]

thank you!   i have the FNA this morning.  biopsy results should be in monday.

[MANmom]

The size of the nodules and the vascularity are a concern, especially vascularity inside the nodule, Cancer needs a blood supply to grow.  Get the biopsy.  All my bloodwork was normal, I still had cancer.  I had a choking feeling and hoarseness, along with the regular thyroid fatigue. hot/cold sensitivity, joint pain. With vascularity, you have @ 20% chance of cancer.  If is is cancer, they will remove the thyroid, but you can do just fine without it.  If it is not cancer, they will still watch it, and eventually it will probably come out.

[Kristina538]

I noticed a lump on my throat about 4 years ago.  My labs looked similar to yours and I was advised I could have surgery if it was uncomfortable (which it wasn't).  I had the FNA which showed the nodule was not cancerous.

Since then my labs have swung more to hyperthroid;  I had an uptake scan which showed the nodule was 'hot' (toxic) and therefore causing the hyperthyroid swing and suppressing the rest of the thyroid.

I now have a choice of RAI treatment or surgery.  I'm a little disappointed I didn't learn more earlier, because the nodule has now made me symptomatic,  which is apparently not good for the surgical procedure..... i.e. I wish I'd done the surgery earlier and didn't realise that a nodule could cause a hyperactive state.  

Of course, your nodule may not be 'hot' or leaning that way, but your lab work does look similar to mine a couple of years ago.   Sorry I can't comment on the rest of your scan results... I have other smaller nodules also, but until they're a certain size,  apparently they pose no risk.  Good luck;  I hope you're seeing a good Endocrinologist who specialises in thyroid.