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Thyroid nodules
My boy 11 years old has a thyroid lump but his doctor can't tell me what it is. Some of his blood test are Eosinophils absolute 364 High (normal range 0-200), Basophils absolute 73 high (normal 0-40), immature granulocytes % 0.1High (normal -<=0.0) and Anti Thyroid Peroxidase 40.1 High (normal range 0.0-35.0).
The WBC count 9.1 (normal 5.0-11.0) and the Red Blood Cell Count is 4.90 ( normal 4-5.2). His TSH is 3.39, Thyroxine Free test is 1.0 and Triiodothyronine is 1.72.
The FNA result is Colloid and Macrophages only: Technically inadequate for diagnosis.
Can somebody help?
The WBC count 9.1 (normal 5.0-11.0) and the Red Blood Cell Count is 4.90 ( normal 4-5.2). His TSH is 3.39, Thyroxine Free test is 1.0 and Triiodothyronine is 1.72.
The FNA result is Colloid and Macrophages only: Technically inadequate for diagnosis.
Can somebody help?
MEDICAL PROFESSIONAL
Sounds like a benign thyroid cyst but would recommend repeat FNA with ultrasound guidance to make certain that any area of suspicion is targeted/sampled. the labs don't help identify the nature of the lump.
MEDICAL PROFESSIONAL
If surgery is done, it is usually the entire lobe.
The hemorrhagic fluid is most consistent with bleeding into the cyst (which is common and usually benign). If it keeps recurring, then surgery is usually the recommendation. In adults, we do sometimes do ethanol injections for benign recurrent cysts. This may also be an option for him.
The areas with increased vascularity need to be targeted during ultrasound guided FNA. Gland vascularity is not specific - given the normal TSH levels, would not read much into that.
The hemorrhagic fluid is most consistent with bleeding into the cyst (which is common and usually benign). If it keeps recurring, then surgery is usually the recommendation. In adults, we do sometimes do ethanol injections for benign recurrent cysts. This may also be an option for him.
The areas with increased vascularity need to be targeted during ultrasound guided FNA. Gland vascularity is not specific - given the normal TSH levels, would not read much into that.
Can the cyst be removed if is benign? (only the cyst not the thyroid lobe). What else can be done to shrink it? He is only 11 year old.
Thank you.
Thank you.
Hello dr. Lupo,
Could you please help me understand the ultrasound result?
From Feb. 24 2014
The right lobe of the thyroid volume is 9.2ml. In the mid to inferior right thyroid lobe there is a complex cystic and solid lesion measuring approx. volume 5.4ml, decreased from Dec ( before FNA the volume was 6.8cc -aspirate material 4cc hemorrhagic fluid but got bigger after few weeks). Increase vascularity within the lesion.
What makes me worry is the increased vascularity within the lesion and diffusely within the bilateral thyroid lobes( the left lobe).What this mean?
His FNA is scheduled in April.
Thank you
Could you please help me understand the ultrasound result?
From Feb. 24 2014
The right lobe of the thyroid volume is 9.2ml. In the mid to inferior right thyroid lobe there is a complex cystic and solid lesion measuring approx. volume 5.4ml, decreased from Dec ( before FNA the volume was 6.8cc -aspirate material 4cc hemorrhagic fluid but got bigger after few weeks). Increase vascularity within the lesion.
What makes me worry is the increased vascularity within the lesion and diffusely within the bilateral thyroid lobes( the left lobe).What this mean?
His FNA is scheduled in April.
Thank you
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