Diagnosis?

[jb41799]

Hi everyone!  If I could have your thoughts, please.  No matter how much research I do, I still feel like I know nothing when it comes to the thyroid.  I'll do my best to give you the short version.  I was diagnosed with nodules on my thyroid in 2005.  At the time, I had bloodwork done, u/s and nuclear uptake and scan.  I apologize, but I can't find my records from then but I do remember it all turned out normal.  Since then, I've been seeing and endocrinologist.  I've been on 75 mcg of Levoxyl since 2005, in theory to keep the nodules from growing.  I got back to the endogrinologist tomorrow for my second FNA biopsy.  I've pulled the following reports for your review:

1/31/2005   Right Lobe measures 4.2 x 1.6 x 1.7cm with a lack of homogeneity and 2 dominant nodules.  A cyst in the upper pole measuring 0.7 x 0.5 x 0.5cm and a complex cyst in the midpolar region measuring 0.9 x 0.9 x 1.1cm.  The left lobe measures 4.2 x 1.0 x 1.6cm with a lower pole cyst measuring 0.3 x 0.2 x 0.3cm  Conclusion:  Bilateral cysts with a complex cyst.  Nuclear uptake and scan are suggested.  

4/13/2007   Right Lobe measures 6.1 x 2.0 x 2.1cm with only a solitary complex nodule currently demonstrated on the midpole measuring 1.0 x 0.8 x 1.0cm.  Minimal peripheral flow is noted.  There is a slight elongation of the right lobe.  The left lobe is normal size and measures 4.6 x 1.5 x 1.8cm.  Isthmus measures 3.1mm  Impression:  Elongation of the right lobe of the thyroid.  Smoothly marginated complex nodule in the midpole of the right lobe is stable whe compared to the previous outside study (compare to 2006 study which I cannot find results for)

3/8/2010  The thyroid is normal in size.  Background parenchyma demonstrates mild, diffuse heterogeneity and normal vascularity.  The right lobe measures 6.1 x 1.6 x 2.1cm.  In the midpole there is a solid appearing hypoechoic nodule which measures 17 x 10 x 15mm, previously 10 x 8 x 10 mm on the April 2007  The left lobe measures 5.5 x 1.1 x 1.8cm.  There is a hypoechoic nodule in the inferior pole measure 4 x 2 x 3mm.  The Isthmus measures 2mm.  No abnormal lymph nodes are indentified.  Impression:  Hypoechoic, solid appearing right thyroid nodule which has increase in size fromt he April 2007 outside u/w.  Percutaneous FNA biopsy is recommended based upon appearance and size of the nodule. (cannot find my fna results)

2/22/11    Right lobe measures 6.5 x 2.3 x 2.6cm.  A nodule is seen on the mid pole which is solid measuring 1.8 x 1.3 x 1.5cm.  A nodule is seen inferiorly measuring 5 x 3 x 3mm.  A nodule is seen superiorly measuring 3 x 2 x 2mm.  Left lobe measures 6.2 x 1.7 x 1.8cm.  A small nodule seen inferiorly measuring 3 x 2 x mm.  Previously noted nodule on the midpole is not seen today.  Conclusion:  Bilateral thyroid nodules.

My question is, what is it or could it be?  I recently had bloodwork and TSH is on lower end of normal range.  Antibodies were all within range as well.  Actually, the only thing showing up was slightly high glucose (possible pre-diabetic).  Thoughts?  Thanks!!!

[jb41799]

Thank you both for responding.  I did not post back yesterday as I was just way too upset.  After sitting at the endocrinologists office for an hour, the nurse advised me they don't take my health insurance.  I had called previously since switching plans and was told it was ok.  I was so upset.

So, now I'm in a holding pattern.  I need to see a new endocrinologist and the first appointment isn't until May 2nd.  He's going to review my file and make recommendations from there.  Almost makes me wish I just opted for TT last year.  The surgeon I had seen was ready to go ahead but the endo wanted to wait and see.

[MANmom]

What could it be?  Could be any number of things, it could be a mass of cells that are benign or it could be cancerous, but the chances of cancer are only 15% or less.  Looks more like a mass of cells rather than cancer to me.  If it were cancer, it would probably have vascularity within the nodule and calcifications, but I stress there is no way to tell for sure from an ultrasound.  The biopsy may tell you more, it may not.  Thyroid disease is notoriously hard to diagnose, most times you won't know what a nodule is until they take it out. You will probably have to have it removed eventually, they probably will not go away.  The nodules are not too big, though, so you can still watch and wait.  

[laura1967]

First question: Are you having your thyroid ultrasounds done at the same location and being read by the same radiologist?
There was a mid pole solid hypoechoic nodule on every film even though the last reading said it was not seen? Seems contradictory to me. If indeed it is solid, they will have a hard time trying to do an FNA and may require a core biopsy. What is your doctor saying about his?