Dysphagia, thyroid complex nodule

[cara150]

I was recently diagnosed with a low right-sided complex thyroid nodule(2.5cm x 1.9cm) and my FNB/FNA last week came back nondiagnostic(they also drained 2cc fluid).  I first noticed it 2nd to difficulty in swallowing (is palpable, soft,  and no lymphadenopathy).  After my first u/s I began to get a tightness high in my throat(epiglottis area) like someone is choking me.  It feels like muscle spasm- it is getting worse and worse.  My throat almost closed earlier in the week while running(I stopped doing that) and yesterday for a time I lost the ability to swallow my saliva(feels like a huge lump in my throat and muscle spasms-even my tongue).  I went to the E.R. yesterday- labs WNL, Neck CT neg.  I know it sounds like G.E.R.D. but it just started 4 wks ago as my thyroid nodule was getting diagnosed- strange coincidence!  I am not an anxious person, I don't have anxiety attacks(type B personality).  I'm 29 y/o female, ICU nurse with a two yr old daughter, no medical history besides C-section and lumbar disectomy.  My TSH was in the 3's and my antibody's were neg.  I'm seeing my I.M. md, endocrinologist, and going to an ENT tomorrow- no one seems to know.  Any ideas or leads to follow?

[Mark Lupo, M.D.]

The neck CT was negative -- did it show the nodule?  Did it re-accummulate a significant amount of fluid after the FNA/drainage?

The thyroid lesion may be unrelatd.  The description of the "globus sensation" warrants ENT evaluation for complete evaluation and to help determine if this may be related to the thyroid.

[cara150]

Thank you for responding.  Yes, I wasn't clear re: the CT.  It did show a 2cm hypodensity where my nodule is.  The radiologist(who did my FNB) said that my original 2.5 x 1.9 nodule was reduced to approx. half it's size 2 weeks ago.  I have also noticed it appears larger when visualized while swallowing.

I also was leaning toward the issues being unrelated.  My I.M. M.D. scoped me in the office last wk(not upper GI- just throat) and it was neg.  I don't really have any symptoms of GERD though.  I've had heartburn about 2-3 times in my life.  I did briefly speak to an ENT at the hospital on Fri. and he told flat out(without testing or exam) that I probably had GERD.  I go today for an official visit with ENT.  What about the medical literature about progressive dyshagia being a sign of malignancy? I'm starting to get a look at what patients go through with all of the scattered care secondary to the natural progression of our specialized health system.

[898]

Any detailed information about cytology of the  aspirated material? (non-diagnostic is the general term)

[cara150]

Aspirated fluid had no colloid matter- other than that I'm afraid I don't know.

[898]

I have read the article about the intranodular hemorrhage, the complex cyst was filled with partially "digested"(?) blood and fibrous tissue. The nodule was rapidly increasing in size, causing shortness of breath; the fluid was aspirated.