What is the signficance of having both hypervascularity in a heterogenious solid nodule?

[hopeful45]

Hello.  My US on my Thyroid found three nodules and one cyst...left side is worst.  
R: 4.8x1.6x1.9cm..midpole - 9x6x5mm cyste and a mildly herterogeneious soldi nodule 6x4x5mm.
LEFT: 4.8x1.5x1.8cm.  Upper pole: heterogenious nodule 1x .8x1cm and LOWER POLE mildly hterogenous solid nodule 2.1x1.4x1.8cm that is hypervascular on color imaging.  
IMPRESSION:  Bilateral Thyroid nodule, with the dominant nodule..left...  Given the size and increased vascularity, consideration for further work up would include thyrod uptake and scan Nuclear Medicine test or ultrasound guided fine needle aspiration.

Questions:  Do I need both tests?  I have a FNA scheduled for next week.  My blood test/level are normal.  How worried should I be.  BTW- the left sided nodule is palpable, especially when swallowing.  Just real nervous being a 45-yr-old single mom of two young boys.  

Thanks!!!

[898]

About every other large benign nodule [50% ot total ] has internal vascularity. The chance of malignancy is about 20% for your case. However this nodule can grow as a result of intranodular bleeding.

[hopeful45]

Thank you for your information last week.  Because of you I made sure I was getting an US-guided FNA and it turned out I wasn't (appointment tomorrow).  So I cleared things up and am scheduled for Wednesday where the radiologist and pathologist will be working together.  
Regarding your last comment to me, could you clarify about "50% benign nodules are hypervascular"?  Also, given my US report, any statistics here?  Just fearful, but still hopeful.

[hopeful45]

Thank you so very much for the info...can u clarify just one more thing?  When you said "50% benign", does that mean there is a 50/50 chance it is malignant?  And does the heterogeneous factor increase my chances of such?  BTW, the large nodule was noticed a year ago by my Gyn but blood tests were normal so no f/up was recommended.  This year's yearly she noticed it increased in size...thus the US, etc.

[898]

The scan is not reallynecessary given the blood tests are normal. The largest nodule must undergo US guided biopsy, [IMPORTYANT] so the needle will take sample from the tissue not the blood vessl.
About 50% of benign nodules have increased vascularity; heterogenious nodule means it has solid and fluid components. If FNA for it will be questionable, biopsy of another solid nodule should be done.
If large nodule was recently appeared it can be formed as a result of bleeding inside the preexisting smaller nodule
Good LUCK!!.