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TR5 Thyroid nodule- should I be worried?

Abnormal ultrasound, as discussed above, including a 1.8 cm TI-RADS 5 right
thyroid nodule. Published guidelines recommend endocrinology consultation and
biopsy. In addition to sampling of the 1.8 cm right posterior mid-upper upper
thyroid nodule, FNA of other portions of the gland containing numerous punctate
echogenic foci, presumed microcalcifications, should also be considered,
particularly in the right lower pole.

The thyroid gland is heterogeneous and demonstrates nodularity of the capsule
contour. The right lobe in particular demonstrates marked parenchymal
heterogeneity and numerous punctate hyperechoic foci throughout the lobe, likely
punctate calcifications. There is a discrete 1.8 cm nodule in the mid to upper
right lobe with suspicious morphologic features, discussed below.

Other small punctate hyperechoic foci are also seen in the isthmus and at the
lower pole of the left lobe, without evidence of discrete isthmus or left lobe
nodule.

Inferior to the left thyroid lobe, an ovoid fusiform structure with smooth
margins measures 1.9 x 1.5 x 0.8 cm, isoechoic to the left thyroid lobe but not
clearly contiguous with it. This may represent ectopic thyroid tissue.

Individual nodules were selected for measurement based on ACR TI-RADS criteria.

Location: Right posterior mid-upper, partially exophytic
Size : 1.8 x 1.2 x 1.5 cm
Composition: Solid: 2
Echogenicity: Mixed hyperechoic and hypoechoic: 2
Shape: Wider than tall: 0
Margins: Irregular: 2
Echogenic foci: Multiple small punctate echogenic foci: 3
Total points: 9
TI-RADS category: 5. Biopsy is advised.
1 Responses
Avatar universal
Hi adys123,

Most thyroid nodules are benign (around 90% are benign).

Your nodule has some characteristics that make it more likely to be cancerous, such as irregular borders, but it does not mean it is cancer, just that a biopsy is needed to determine if it is benign or not.  If it does end up being cancerous, most thyroid cancers are very slow growing and treatable.

As for the rest of thyroid morphology - I have no idea what punctate calcifications would mean when spread throughout the thyroid.  If calcifications are present in a nodule that usually means a greater risk of cancer (still does not mean it is cancer), but spread throughout the thyroid tissue itself I wouldn't assume that was necessarily cancer related.

I have Hashimoto's, and my thyroid tissue was described as "heterogeneous with nodularity" on my ultrasound.  Since your ultrasound notes heterogeneity and nodularity of the thyroid tissue, if you have not been tested yet, I would suggest asking your doctor for a thyroid antibody test to see if you have Hashimoto's or Graves diseases which are two autoimmune diseases that attack the thyroid, and can cause nodularity or heterogenous texture on ultrasounds.

Do you have any hypothyroidism or hyperthyroidism symptoms?  Hashimoto's can cause both hyperthyroidism and hypothyroidism symptoms, Graves causes hyperthyroidism.

Good luck with your biopsy, I hope all goes well for you.
2 Comments
I have always had elevated TPO antibodies but all my other thyroid testing usually comes back normal
Thank you for your response :)
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