Thyroid Nodules

[Ladybug414]

Hi, I'm a 44 year old woman. I've know I had at least a nodule in my thyroid for about 17 years now. I discover it myself years ago. It's been biopsy in the past with no real concern. I was told that it should monitor. In the past and present my blood work shows a normal active thyroid, even though I believe I suffer from hypothyroidism.
My concern is that I haven't been a good patient. I don't go to the doctor on a regular basis. I did not continue with my endocrinologist and have follow up check-ups. I just let things go. This past February I was sick with the Flu, so sick that I actually went to a doctor, Which I haven't seen in about 5 yrs. She started the ball rolling to get some tests done. I'm scheduled to meet with an endocrinologist the end of July. I was interested in some feed back from my ultrasound results. Thanks for your time, knowledge and advice on this matter.

Ultra Sound of Thyroid
Comment: the right thyroid lobe measures 8.1 x 4.7x 3.4 cm. It's architecture is heterogeneous. Within the midportion and right lower pole of this lobe is a 6cm solid heterogeneous nodule. Much of the periphery of the nodule is isoechoic to the thyroid lobe and the central portion demonstrates heterogeneous hypoechoic tissue and small foci of cystic degeneration. The isthmus measures 4 mm. The left lobe is minimally heterogeneous measures 4.6 x1.4 x 1.3 cm. within its lower pole is a 0.9 cm cystically degenerated nodule.
Impression:  multinodular thyroid gland. Previous studies are currently not retrievable. A right thyroid nodule was described in 1997 measuring 2.5 cm and was also delineated in 2002 measuring 4.2cm. Therefore, the right thyroid nodule has increased in size and clinical correlation is advised

[Ladybug414]

Dr. Lupo, thank you for your time and knowledge. I'm heading to the endocrinologist on Monday.  I did get a copy of my blood work.  My TSH 3.44
T4 free 1.0. - T3 uptake 27. Cholesterol high. (Total 225) LDL(153) nonHDL(170); vitamin D  low (16); MCV 78.3; MCH 25.5; RDW 17.2
Iron low (Total 23).  Thank you again for your insight.  I'm sure I'll have more questions to post in the near future.

[Mark Lupo, M.D.]

6cm (over 2 inches) is a very large nodule and it has grown signifcantly (but slowly) over the last 16 year -- many would recommend surgery based on size and growth, but a TSH test then possible repeat biopsy should be done first to help sort this out.  Also, expert neck ultrasound by a physician to check for lymph node abnormalitites or other problems not detected on routine ultrasound.  This is most likely a benign nodule that is not impacting thyroid funciton but the growth and current size make surgery a reasonable choice.