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Should I be worried?
Hello Everyone,
I am hoping I can get some opinions on my ultrasound results. First let me start by stating that all my thyroid tests came back normal except for the TPO blood test that was high at 152. I also have a history of thyroid disease in my family. My mother and sister are both hypo and my brother had graves disease which later turned to hypo. Here are my ultrasound results any comments would be greatly appreciated.
The right thyroid lobe measures 5.3 x 2.0 x 1.8 cm. The left thyroid lobe measures 5.5 x 1.4 x 1.7 cm. The isthmus measures 5mm. The thyroid gland is diffusely heterogeneous with more focal areas of altered echo texture identified. For example, in the medial right thyroid lobe is a mixed cyst and solid nodule which measures 2.2 x1.5x1.2 cm. Within the inferior left thyroid lobe and mid medial left lobe is a second nodule with similar appearance demonstrating mixed solid and cystic components measuring 1.8 x 0.8 x 1.0 cm. Inferior to the left thyroid lobe is a 2.2 x 0.6 x 0.8 cm nodule which demonstrates also similar appearance of cystic and solid component with a pattern most suggestive of an exophytic inferior left thyroid nodule.
Impression: Enlarged diffusely heterogeneous thyroid gland identified with multiple mixed cystic and solid nodules, as described above. Clinical correlation is advised and if clinically indicated a fine needle aspiration with ultrasound guidance can be performed.
My Endo says I don't need a biopsy and this kind of goiter is very common. She has put me on medication to try and reduce the goiter. Should I push for a FNB or is this fairly normal.
Thanks, Corky
I am hoping I can get some opinions on my ultrasound results. First let me start by stating that all my thyroid tests came back normal except for the TPO blood test that was high at 152. I also have a history of thyroid disease in my family. My mother and sister are both hypo and my brother had graves disease which later turned to hypo. Here are my ultrasound results any comments would be greatly appreciated.
The right thyroid lobe measures 5.3 x 2.0 x 1.8 cm. The left thyroid lobe measures 5.5 x 1.4 x 1.7 cm. The isthmus measures 5mm. The thyroid gland is diffusely heterogeneous with more focal areas of altered echo texture identified. For example, in the medial right thyroid lobe is a mixed cyst and solid nodule which measures 2.2 x1.5x1.2 cm. Within the inferior left thyroid lobe and mid medial left lobe is a second nodule with similar appearance demonstrating mixed solid and cystic components measuring 1.8 x 0.8 x 1.0 cm. Inferior to the left thyroid lobe is a 2.2 x 0.6 x 0.8 cm nodule which demonstrates also similar appearance of cystic and solid component with a pattern most suggestive of an exophytic inferior left thyroid nodule.
Impression: Enlarged diffusely heterogeneous thyroid gland identified with multiple mixed cystic and solid nodules, as described above. Clinical correlation is advised and if clinically indicated a fine needle aspiration with ultrasound guidance can be performed.
My Endo says I don't need a biopsy and this kind of goiter is very common. She has put me on medication to try and reduce the goiter. Should I push for a FNB or is this fairly normal.
Thanks, Corky
In theory, if the gland is non-tender that should not be the case; these symptoms often found among the patients with substernal thyroid extension. But actual symptoms are vary from person tho person..
Thank your your feedback. I haven't noticed any real issues, as a matter of fact I wouldn't even now that these nodules were there if my doctor had not ordered a full thyroid panel and noticed the elevated TPO. The Endo look at my lab work and felt my throat and stated that my thyroid was indeed a little enlarged. She didn't order the ultrasound, but after reading several posts on this forum I called and requested one. I have noticed that if I try to go to sleep laying on my back that I will jerk awake feeling like i am not able to breath correctly. Could this have something to do with the nodules or enlarged thyroid?
According to the clinical practice, the palpable nodules larger then 1 cm are these which needed to be biopsied.
The highest concern is given to the nodules which has calcification, solid hypoechoic, cold on the scan but have well develped internal vascularity [per Doppler color flow imaging].
In addition the single nodule in otherwise normal thyroid [normal levels, and no elevated antibodies sugeesting of Hashimoto's chronic thyroiditis] is most worrysome.
In your particular condition, the nodules are complexby the composition [undergoing cystic degeneration] and meet size criteria for FNA, however you have Hashimoto's condition which explain why these nodules are present[elevated TPOand inflammatory texture of the thyroid tissue.
In order to be safe you may have to schedule a biopsy of the largest nodule.
the guidelines for biopsy are in the Welcome thread to this forum, so you may read these.
Good luck
The highest concern is given to the nodules which has calcification, solid hypoechoic, cold on the scan but have well develped internal vascularity [per Doppler color flow imaging].
In addition the single nodule in otherwise normal thyroid [normal levels, and no elevated antibodies sugeesting of Hashimoto's chronic thyroiditis] is most worrysome.
In your particular condition, the nodules are complexby the composition [undergoing cystic degeneration] and meet size criteria for FNA, however you have Hashimoto's condition which explain why these nodules are present[elevated TPOand inflammatory texture of the thyroid tissue.
In order to be safe you may have to schedule a biopsy of the largest nodule.
the guidelines for biopsy are in the Welcome thread to this forum, so you may read these.
Good luck
Hello 898,
Thank you for your comment. So in your opinion a biopsy isn't really necessary? Although my mother, sister, and brother have all had thyroid dysfunction (not cancer), I am relatively new at trying to understand what is worrisome and what is not. I really do not want to ask my mother these questions as it will cause her concern and she has been through a lot since the loss of my father and if I ask my brother and sister questions she is sure to catch wind of it. The Endo wants to monitor these without doing a biopsy, but I get real nervous with anything that could be cause for concern. I watched my father pass away from bladder cancer and although he had been to the doctors numerous times he was told that he just had a bladder infection. I guess I find it hard to trust too much in any doctor.
Thank you for your comment. So in your opinion a biopsy isn't really necessary? Although my mother, sister, and brother have all had thyroid dysfunction (not cancer), I am relatively new at trying to understand what is worrisome and what is not. I really do not want to ask my mother these questions as it will cause her concern and she has been through a lot since the loss of my father and if I ask my brother and sister questions she is sure to catch wind of it. The Endo wants to monitor these without doing a biopsy, but I get real nervous with anything that could be cause for concern. I watched my father pass away from bladder cancer and although he had been to the doctors numerous times he was told that he just had a bladder infection. I guess I find it hard to trust too much in any doctor.
The nodules are of the same composition and most likely contained debrees from the chronic thyroid inflammation; the biopsy of largest nodule can be helpful, but monitoring them for the size changes is also recommended.
I am sorry to hear that you need to go through more waiting and worrying and I hope that your doctor got it all to begin with. Are you having another surgery in two months to remove the lymph nodes for biopsy and if so why do you need to wait two months? Or is your doctor going to scan you in two months to check for lymph node activity? Thank you for your feedback, which I agree with. I just wanted to get some advice from people who are in similar situations and reassure myself that it wasn't an overreaction to want the FNB done. Please let me know how your doing and how your current situation plays out. Hoping for the best and good luck!
i would push for a FNB if i was you.
although it doesnt sound too suspicious as both lobes are larger, you dont need to take a chance and what does it hurt to have another dianostic tool to rule out anything else?
I am one that belives that no chances should be taken, more so since i was diagnosed with thyroid cancer at 22 yrs old. my doctor dod a total thyroidectomy but didnt check the lymphnodes because he assumed that the mass wouldnt be cancerous...he was wrong and now i have to wait 2 months to see if it's spread!
it's your body and your peace of mind and you have the right to a FNB
although it doesnt sound too suspicious as both lobes are larger, you dont need to take a chance and what does it hurt to have another dianostic tool to rule out anything else?
I am one that belives that no chances should be taken, more so since i was diagnosed with thyroid cancer at 22 yrs old. my doctor dod a total thyroidectomy but didnt check the lymphnodes because he assumed that the mass wouldnt be cancerous...he was wrong and now i have to wait 2 months to see if it's spread!
it's your body and your peace of mind and you have the right to a FNB
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