Thryoid Ultra Sound

[scaredandconfused84]

I am wondering if anyonce can shed some light on this for me. I am getting a biopsy on Wednesday at 2pm that is 10/29/14 I was wondering if anyone could tell me if any of these sound like cancer.



Ultrasound of the thyroid gland dated 10/20/2014.

Clinical indication: Thyroid nodule.

Both lobes of the thyroid gland are normal in size shape and texture.

The right lobe measures 4.3 x 1.8 x 2 cm.

Left lobe measures 4.2 x 0.93 x 1.7 cm.

The isthmus has a normal thickness of  0.23 cm.

At the lower pole of the light right lobe of the thyroid gland there is a
lobulated heterogenous slightly hypoechoic nodule with  tiny foci of
calcifications measuring 2.3 x 1.3 x 1.9 cm. There is some vascular flow
present within the nodule. Biopsy of this nodule is recommended.

Impression:

Normal-sized thyroid gland with a lobulated nodule with calcifications within
it. Biopsy of the nodule is recommended.

Any replies would be greatly appreciated.

[scaredandconfused84]

I just got the fax from U of M.They say. I do think this biopsy shows diagnostic features of Papillary carcinoma. The nuclear changes are quite characteristic and show overlapping, optical clearing and some nuclear grooves. If these small pieces are representative of the larger mass, this would be follicular variant of papillary carcinoma.

[898_1]

Ultrasonographic features (eg, a solid echo structure, microcalcifications, and a hypoechoic pattern) were predictive for malignant neoplasms.
Please get copy of pathology report gross and microscopic sample (to make sure it is properly prepared)
Will  be looking for scant colloid, sheets of follicular cells microfolliciular pattern of cell arrangement.

[scaredandconfused84]

They had the cells sent off to U of M for further analysis. Follicular Neoplasm. 30 percent chance its cancer. Should hear back tomorrow. Was not happy about this.

[898_1]

Nobody want to hear bad news.
This is why in the past the angry public directed anger toward doctors.
However... the ultrasound description is made by human so errors always possible (calcification pattern can be inaccurately described, for example)

[scaredandconfused84]

Still waiting for the results...I am really nervous I don't wanna hear bad news.

[scaredandconfused84]

Not what I wanted to hear and the fact that it had microcalcifications and blood flow I am probably screwed.

[898_1]

Not necessary. Some of the doctors feel it is easier to "sell" a surgery to the patient during office visit.
In any case be sure to get a copy of the report and if surgery is proposed seek second opinion! Even in event of cancer some docs are  removing thyroid only  forgetting to check if there are some suspicious lymph nodes are left out so the cancer may return.

[scaredandconfused84]

My endocrinologist has my biopsy results but won't tell me what they are till my appointment on Monday. If they were bad wouldn't they call me and tell me that I need surgery?

[scaredandconfused84]

I really hope it comes back benign

[898_1]

Looks good; IMO there should be no blood contamination of the sample

[scaredandconfused84]

Doesnt look bruised and there was only a tiny amount of blood on the bandaid, ya know so it has time to clot. Doesn't hurt or anything here is what it looks like. https://fbcdn-sphotos-e-a.akamaihd.net/hphotos-ak-xap1/v/t1.0-9/10354993_10152326758186548_9078853410201781420_n.jpg?oh=4ddcb97cfee3d6db730d85cce2c3e1f4&oe=54E99409&__gda__=1420578908_b44f228fde9667fd4bf2408d69883f22

[scaredandconfused84]

Haven't taken the bandaid off yet and he didn't mention anything about blood in the samples. He took 4 or 5. It's a little sore but no pain at all. They said to leave my bandaid on till today. But they didn't indicate anything serious.

[898_1]

When are you going to have a result ? have you noticed any blood in sample? do you have a bruise?

[scaredandconfused84]

Ultrasound-guided biopsy thyroid nodule right dated 10/29/2014 at 2:09 PM

Reason for study thyroid mass

Patient presents for ultrasound-guided biopsy of a dominant nodule involving
the right lobe of thyroid gland. Following verbal and written consent,
preprocedure verification timeout was performed.

With sterile technique under local anesthesia and ultrasound guidance a biopsy
needles inserted into the lesion. Multiple passes are made with tissue sent
for histopathologic assessment.

Impression: Ultrasound-guided biopsy dominant nodule right lobe thyroid gland.
  

[scaredandconfused84]

Wow this valium is still doing a number on me. I got the biopsy done. The doctor who did it reassured me that over 90 percent of his biopsies were benign. And he didn't indicate anything really serious when he talked to me and he said not to worry that I should be ok. I asked about the micro calcifications and the blood flow and he didnt say anything to indicate I needed surgery.

[scaredandconfused84]

Got the biopsy done. Neck is a little more. They reassured me that over 90 percent of his biopsies that he has done have been benign and that I should be ok. He didn't notice anything too serious on the Ultra Sound. If he had I believe he would have told me?

[scaredandconfused84]

Heading to the biopsy here in a few minutes. Probably wont be able to post anything until Monday when I see the Endocrinologist. Here is hoping for good news.

[898_1]

You should be able to get one from the pharmacy; the hospital may have it upon request

[scaredandconfused84]

Ok. We actually don't have an ice pack, would they have one at the hospital?

[898_1]

Let's go one step at the time:) and focus on biopsy
If nodule is questionable (adenoma vs. neoplasm) you may have an option to monitor it for 3 to 6 months and then repeat all tests and make a final decision.
The biopsy should be done under live observation ultrasound in order to avoid as many blood vessels as possible, because blood washes out colloid from the sample so the nodule can be mis-diagnosed as neoplasm (which normally has little or no colloid)
Next, the sample must be properly prepared for microscopic examination (cell block versus thin preparation)
Finally, all available information should be included in the report.
Bring the ice pack with you and apply it as soon as procedure is done to avoid bruise!!
(Not sure if eating ice cream cone will help in this case:)

[scaredandconfused84]

I sent it to myself by accident but do you know if they do robotic surgery for it ? I heard it takes less time and its not going to leave a scar on my neck.

[scaredandconfused84]

Also does anyone know if they do robotic surgery? I heard its less time and there is no scar on the neck to worry about.

[scaredandconfused84]

Ok well the only thing I can really do is try to remain positive and hope for the best. But why would they want to make the TSH level go down if I am in the normal range of 2.6? I would much rather try something else instead of surgery, but I guess if surgery is really the only way to deal with it  guess that is what I will have to do. Do you know if they put you out and have to put breathing tubes in or whatever or do they just sedate you but you can still breath on your own? That is one thing I am worried about because I have heard they have to put breathing tubes in and I don't do well with gagging and whatnot.

[898_1]

So far there are 2 known minimally invasive methods to shrink the nodule:
Injection of ethanol (PEI) works best on cystic or mixed nodules;
Wave frequency ablation ("microwave cooking" of nodule tissue), works on most nodules however is not widely used.
About 30% of nodules shrink if  TSH is brought down to less than 0.5 either by thyroid hormone or Metformin. It is hard to say if you will have to take hormones after lobe removal.