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Still confused about my results after 5 months.  

Feb 07, 2010 - 7 comments

What would you make of this? I am confused after reading some of the many posting.   I was just diagnosed with Obstructive Sleep Apnea.  I read that  the thyroid can contribute to the Obstructive apnea.  Well how enlarged my thyroid need to be to be considered a problem.  

See below my last two ultrasound and blood test:

US Thyroid  March 14,  2009
History: Suspicion for right thyroid nodule.

Sonographic   evaluation of the thyroid demonstrates the gland to be enlarged and heterogeneous.  The right lobe measures 6.4 x 2.7 x 2.5 cm, the left lobe measures 6.2 x 2.2 x 2.5 cm.  The isthmus measures 0.6 cm .  There is no cervical lymphadenopathy.

There is a complex nodule within the central right lobe which is echogenic.  There is a cystic component centrally.  The nodule measures 2.3 x 2.0 x 2.1 cm..  A second nodule in the right lobe medially measures 1.1 x 0.8 x 1.1 cm.  There is a nodule at the mid to superior left lobe anteriorly  measuring 1.3 x 0.9 x 1.3 cm..  A coarse calcification is seen within the central left lobe.  There is a relatively echogenic nodule inferiorly and anteriorly measuring 1.4 x 0.9 x 1.1 cm..  Additional nodule within the left lobe at the mid left lobe measures 1.0 x 0.7 x 0.9cm..

Impression:

Multinodular goiter.  There is a dominant nodule in the right lobe as described.


Repeated the Thyroid Ultrasound on September 12, 2009

Findings:
Right lobe; measures 5.9 x 2.8 x 2.8 cm.  Complex predominantly solid nodule in the right midpole measuring 2.4 x 2.1 x 2.4 cm grossly unchanged from prior exam.  

Left lobe measures 7.1 x 2.6 x 2.9 cm..  There is heterogeneous nodule in the lower pole measuring 1.8 x 1.8 x 1.5 cm and is slightly more prominent on prior exam where it measured 1.4 cm.  however this may be technical in nature.  There is a mid to lower pole nodule measuring 1.3 x 0.9 c 1.0 cm hypoechoic, unchanged.  There is a mid to upper pole nodule measuring 1.3 x 1.0 x 1.5 cm with punctuate echogenic foci for which microcalcifications cannot be excluded, unchanged from prior exam.  There is a gross dystrophic calcification the midpole measuring 6 mm likely unchanged when allowing for technical differences.  A benign lymph node is seen in the left neck measuring 1.2 x 0.4 x 0.8 cm.  

Isthmus: mesures 2.7cm.  In the right isthmus there is vascular 1.1 x 0.9 x 1.1 cm heterogeneous hypoechoic nodule unchanged .



Blood Test :   August 31, 2009  

TSH  -      0.75     Range 0.34-5.60
T4 Free -  0.86     Range 0.58 – 1.64
Thyroglobulin AB  557    Range <20
Thyroid Peroxidase AB 15  Range  < 35

After all this  I am very confused and concerned that my endocrinologist told me to see her in one year.  


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1204245_tn?1356904325
by 898_1, Feb 08, 2010
"There is a mid to upper pole nodule measuring 1.3 x 1.0 x 1.5 cm with punctuate echogenic foci for which microcalcifications cannot be excluded," this should possibly be re-evaluated with FNA due to blood flow and possible microcalcification.


1204245_tn?1356904325
by 898_1, Feb 08, 2010
If after elevating your arms above you shoulders you having shortness of breath the thyroid causes the obstruction

107693_tn?1252868043
by neurotic, Feb 08, 2010
I had FNA on a complex nodule within the central right lobe which is echogenic.  There is a cystic component centrally.  The nodule measured 2.3 x 2.0 x 2.1 cm,  The results were negative. This was done after the first ultrasound.  The second ultrasound the doctor said no change see you in one year.

1204245_tn?1356904325
by 898_1, Feb 08, 2010
Nodules with blood flow and microcalcification are usually considered most suspicios and biopsied first; nodule without blood flow contains dead tissue and most often benign, even if it is largest in size

107693_tn?1252868043
by neurotic, Jul 31, 2010
I had some pain on my right side, went to to see the endo doctor on July 23, 2010, did blood test  and the results are normal.  She sent me for an Ultrasound..... compared to 9/12/2009

History: Multinodular goiter.

The right lobe measures 4.9 x 2.4 x 3.2 cm, the left lobe measures 5.0 x 2.2 x 2.6 cm.  The isthmus measures 0.9 cm.  There is no cervical lymphadenopathy.

There is  a dominant complex echogenic nodule within the central right lobe measuring 2.3 x 2.0 x 2.4 cm.  It is solid with cystic foci.  A smaller nodule seen in the right lateral isthmus measures 1.1. x 1.1 x 1.0 cm. There is a nodule within the left lobe anteriorly measuring 1.5 x 1.0 x 1.5 cm.  A relatively echogenic nodule is seen inferiorly and anteriorly within the left lobe measuring 1.4 x 1.3 x 1.2 cm.  

Impression:
several nodules bilaterally.  There is dominat nodule within the central right lobe which is stable from prior examination.

My question is:  

in the last ultrasound there were 5 nodule, in these new US there are only 4.  What happened to the other, do they disappear?  The left lobe measurement the previous one it was 7.1 x 2.6 x 2.9 cm.  and now it is 5.0 x 2.2 x 2.6 cm.  is this considered a good thing and does the thyroid shrink .  I am not an any medication.



Avatar_f_tn
by Junebug707, Dec 17, 2011
I have a 2.1 x 1.4 x 1.2 cm mid to lower pole nodule. Its echogenic and solid in nature. This is a dominant nodule.I am scheduled to have a biopsy FNA.What is your opinion?

Avatar_f_tn
by Junebug707, Dec 17, 2011
I also have hoarseness now for the last 3-4 months which from what I have read can be worrisome.

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