US: what might "diffusely hetero w cystic degeneration throughout" indicate?

[kaynay1411]

This started with dysphagia, which led to learning that something was compressing my esophagus. Here is information from the ultrasound of my neck. I see my doctor next week. My overall TSH level is 0.91.

The right lobe of the thyroid measures 2.4 cm AP x 3.2 cm transverse x 7.3 cm
longitudinal, with estimated volume of 20.7 mL. The right lobe of the thyroid is diffusely
heterogeneous with cystic degeneration throughout. There is a dominant anechoic
nodule with internal septation and peripheral vascularity that measures 1.7 x 1.9 x 2.2
cm in the inferior right lobe of the thyroid. This is suggestive of colloid cyst.

Oh, and my left thyroid lobe is missing!

[Red_Star]

It means your thyroid gland..umm lobe lol hates you.

Dr Lupo mentions this on one of his medhelp answers...

"About 1 in 2000 people are born with only one thyroid lobe --- and usually it's the left that is missing.  It does not usually alter thyroid function."

Who needs a left lobe anyway eh? Your right thyroid lobe is not amused as it's doing all the work.  :)  A normal sized thyroid lobe is about 7 to 11 cc (I believe that is equivalent to ml) per lobe. Yours is about double the size really.

A heterogeneous thyroid gland is associated with diffuse thyroid disease including Hashimoto's thyroiditis and Graves' disease. You would need more tests to confirm which one you have.

Cystic degeneration is and to quote "deterioration of specific tissues, cells, or organs with corresponding impairment or loss of function, caused by injury, disease, or aging." Well..yes..it's a messy battle going on in there. And a colloid cyst...kind of like a grape..sitting there calmly in the midst of it. smh.

[kaynay1411]

Wow, thanks for your response. What comes next? Could it still be hashimotos or graves if my TSH is in the normal range?

[kaynay1411]

I'll see if my pcp will run the appropriate blood work. Symptoms include dysphagia, sense that something is in my throat, discomfort in my neck, ongoing aching pain in neck/shoulders/back for about  6 months, dry mouth.

[Red_Star]

Your thyroid isn't happy for sure. I personally had a sore throat and a lump in throat feeling with Hashimot'os thyroiditis.  See what your labwork shows up.

[Red_Star]

TSH can be in range with autoimmune thyroid disease. You can have Hashimoto's thyroiditis or Graves disease with or without symptoms.  Do you have any symptoms? Blood tests for suspected autoimmune thyroid disease include...

TSH
Free T4
Free T3
Thyroid peroxidase antibody (TPOAb)
Thyroglobulin antibody (TgAb)
Thyroid-stimulating Immunoglobulin (TSI)*

*Also goes under the names TSH receptor antibodies (TRAb) or TSH stimulating antibodies (TSAb).  Positive TSI results are strongly indicative of Graves disease but do not always correlate with the presence and severity of hyperthyroidism.