Aa
diffuse thyromegaly with multiple solid nodules
Can any one interpret my thyroid ultasound it goes like this..
Right Thyroid =60x19x28mm
Volume =16.6ml
Left thyroid =63x22x22mm
Volume =15.9ml
Isthmus =7.1mm
Both lobes including the isthmus are enlarged.
The echopattern is inhomogeneous.
There multiple hypoechoic solid nodules seen the right lobe ranging 5-6mm in diameter.
There is a hypoechoic solid nodule seen in the isthmus measuring 5mm in diameter.
negative for calcifications.
Vascular structures and strap muscles are unremarkable.
IMPRESSION:
DIFFUSE THYROMEGALY WITHMULTIPLE SOLID NODULE IN THE RIGHT LOBE AND IN THE ISTHMUS.
Please i am so worried about the result of my ultrasound..can you help me understand this?
Right Thyroid =60x19x28mm
Volume =16.6ml
Left thyroid =63x22x22mm
Volume =15.9ml
Isthmus =7.1mm
Both lobes including the isthmus are enlarged.
The echopattern is inhomogeneous.
There multiple hypoechoic solid nodules seen the right lobe ranging 5-6mm in diameter.
There is a hypoechoic solid nodule seen in the isthmus measuring 5mm in diameter.
negative for calcifications.
Vascular structures and strap muscles are unremarkable.
IMPRESSION:
DIFFUSE THYROMEGALY WITHMULTIPLE SOLID NODULE IN THE RIGHT LOBE AND IN THE ISTHMUS.
Please i am so worried about the result of my ultrasound..can you help me understand this?
Ultrsonogram of Thyroid Glands
Both lobes of thyroid gland is mildly enlarged in size.(Right lobe is 1.8cm.Left lobe is 1.5cm in AP diameter)with fairly uniform echo texture.
There is a hypo-echoic solid nodule seen in the right sided of the isthmus measuring about(1.5cm*0.8cm).
The doctor wrote comments:
1.Mild thyromegaly with fairly uniform echo texture.
2.Nodule in right sided of isthmus
I need help please,i would be very much obliged for your answer
Both lobes of thyroid gland is mildly enlarged in size.(Right lobe is 1.8cm.Left lobe is 1.5cm in AP diameter)with fairly uniform echo texture.
There is a hypo-echoic solid nodule seen in the right sided of the isthmus measuring about(1.5cm*0.8cm).
The doctor wrote comments:
1.Mild thyromegaly with fairly uniform echo texture.
2.Nodule in right sided of isthmus
I need help please,i would be very much obliged for your answer
Dear Aimee,
Found a great video on You Tube: This doctor has posted many vidoes I think will put you at ease.
He states the guidelines for FNA are that an FNA is not ordered unless they are greater than 1cm in size. Other postings by the same Doc go over the goiter in detail>
My ENT surgeon who is the head of otolarangolgy at UAB confirmed to me that FNA can cause a misdiagnosis of cancer upon biopsy of the gland due to scarring from the needle, and confirmed the studies are correct.....also: he said that nodules so small (less than a cm) are so diffiucult to obtain any conclusive results (cant get enough to sample from it).
Hope this helps put you at ease:
http://www.youtube.com/watch?v=b3yxnn5tlt8&feature=relmfu
Found a great video on You Tube: This doctor has posted many vidoes I think will put you at ease.
He states the guidelines for FNA are that an FNA is not ordered unless they are greater than 1cm in size. Other postings by the same Doc go over the goiter in detail>
My ENT surgeon who is the head of otolarangolgy at UAB confirmed to me that FNA can cause a misdiagnosis of cancer upon biopsy of the gland due to scarring from the needle, and confirmed the studies are correct.....also: he said that nodules so small (less than a cm) are so diffiucult to obtain any conclusive results (cant get enough to sample from it).
Hope this helps put you at ease:
http://www.youtube.com/watch?v=b3yxnn5tlt8&feature=relmfu
Please let me know when you go to the Doctor next time. I just want you to know that I am here for you and will say a special pray for you daily. I hope that your fears can be lessened after you talk to your doctor. You need to tell your doctor that you are afraid. And remember that just because someone else (your friend) had pain does not mean that you will. Are you more afraid of the pain or what your results will be?
Of course, I am not a doctor so I really can't give you the advice that you are seeking. But I can tell you that I have faced many tests, surgeries and had both good and bad results, but with a positive attitude and having someone to express your concerns and fears does help in any case. That with your faith in God to give you the strength to get thru it ,good or bad, is the best!!!
I wish you good luck and good results!!!
If you want to chat with me you can send me a message thru the mailbox (up top under inbox). I will send you a short message so you will see that you will have a message.
Sass
Of course, I am not a doctor so I really can't give you the advice that you are seeking. But I can tell you that I have faced many tests, surgeries and had both good and bad results, but with a positive attitude and having someone to express your concerns and fears does help in any case. That with your faith in God to give you the strength to get thru it ,good or bad, is the best!!!
I wish you good luck and good results!!!
If you want to chat with me you can send me a message thru the mailbox (up top under inbox). I will send you a short message so you will see that you will have a message.
Sass
COMMUNITY LEADER
I don't dispute that the parathyroids are very important; they control the calcium levels, which in turn control electrical impulses in your body.... this is a big issue.
I don't dispute any of that, I simply want to get to the bottom of Aimee's issue, which is still relatively vague at this point, because we don't know even what her thyroid levels are, what she's been tested for, autoimmune issues, etc....... most importantly, we don't know if she needs thyroid surgery so the parathyroid issue may be irrelevant for her.... I'd not want her to be frightened away from having necessary diagnostics (FNA) on the basis of someone elses bad experience.
I'd have to ask you, though -- you have 4 parathyroids; are they all damaged? Many people have parathyroid tumors on one gland, but as long as the others work properly, it's not usually an issue....
I *do* wish you the very best of luck .........
I don't dispute any of that, I simply want to get to the bottom of Aimee's issue, which is still relatively vague at this point, because we don't know even what her thyroid levels are, what she's been tested for, autoimmune issues, etc....... most importantly, we don't know if she needs thyroid surgery so the parathyroid issue may be irrelevant for her.... I'd not want her to be frightened away from having necessary diagnostics (FNA) on the basis of someone elses bad experience.
I'd have to ask you, though -- you have 4 parathyroids; are they all damaged? Many people have parathyroid tumors on one gland, but as long as the others work properly, it's not usually an issue....
I *do* wish you the very best of luck .........
The parathyroid is VERY important when having thyroid surgery...watch that video, and see, they look to be attached to the back of the thyroid gland...and for goodness sakes, I am just saying check the blood test if symptoms are present and a high calcium is measured...
And yes, I have been to bad doctors in every field, they are all human, but there are some really good ones, and again, that's why I do my homework now instead of trusting every bit of advice I get...
I check it out, to avoid another misdiagnosis...like they just tried to do on me again two weeks ago...after having high calcium and high PTH measurements for the last six months, suffering, I finally got to see a .....top notch ENT surgeon, who just changed my diagnosis from primary HPTH, now to secondary due to low vitamin D....
This is NOT right... secondary causes high PTH and LOW calcium....I have never had low calcium, and I do not have kidney failure or MEN syndrome....so, Im done with trying the convenient route and pick a doc based on ratings or word of mouth, that doesn't mean squat if he doesn't understand the nature of this disease....
I will go to Tampa to see the best and have my nodules and parathyroid tumors out with the M I R P...with a 99.6 percent CURE rate...tired of the run around and bad advice....its just wrong. Six months of trying to avoid full on exploratory surgery, and then he wants me to start taking vitamin D to see if that will help to lower my calcium level.....what crap.
Wish me luck!
And yes, I have been to bad doctors in every field, they are all human, but there are some really good ones, and again, that's why I do my homework now instead of trusting every bit of advice I get...
I check it out, to avoid another misdiagnosis...like they just tried to do on me again two weeks ago...after having high calcium and high PTH measurements for the last six months, suffering, I finally got to see a .....top notch ENT surgeon, who just changed my diagnosis from primary HPTH, now to secondary due to low vitamin D....
This is NOT right... secondary causes high PTH and LOW calcium....I have never had low calcium, and I do not have kidney failure or MEN syndrome....so, Im done with trying the convenient route and pick a doc based on ratings or word of mouth, that doesn't mean squat if he doesn't understand the nature of this disease....
I will go to Tampa to see the best and have my nodules and parathyroid tumors out with the M I R P...with a 99.6 percent CURE rate...tired of the run around and bad advice....its just wrong. Six months of trying to avoid full on exploratory surgery, and then he wants me to start taking vitamin D to see if that will help to lower my calcium level.....what crap.
Wish me luck!
COMMUNITY LEADER
I had a hysterectomy in 1996, and was on HRT for several years following; I had no issues at that time with my thyroid; I was only diagnosed with hypothyroidism a little over 3 yrs ago. Granted that all the hormones must work together in order for one to be healthy.
I can very easily tell that you've been burned, and that's really too bad; I'm sorry for anyone who has been treated poorly or incompetently, including myself; however, I think in Aimee's case, we should find out exactly what's wrong with her thyroid before we go into discussion of parathyoids, etc, since the only relationship they have with the thyroid is their location in the body; the glands perform very different roles, and not every FNA is going to result in TT or damage to parathyroids.
Strange as it may seem, it was actually an ENT who diagnosed my Hashimoto's, then sent me on to my endo. If I ever did have to have TT, I'd certainly go back to my ENT; he did 2 surgeries on my vocal cords that allow me to talk today, and he does do thyroid removal. It's possible that you might not have had the same issues with an endo, but on the other hand, the wrong endo could have made things 10 times worse.
We all want to help people avoid incompetent treatment; however, I think it's important to get as many facts as possible regarding a person's specific situation.
I can very easily tell that you've been burned, and that's really too bad; I'm sorry for anyone who has been treated poorly or incompetently, including myself; however, I think in Aimee's case, we should find out exactly what's wrong with her thyroid before we go into discussion of parathyoids, etc, since the only relationship they have with the thyroid is their location in the body; the glands perform very different roles, and not every FNA is going to result in TT or damage to parathyroids.
Strange as it may seem, it was actually an ENT who diagnosed my Hashimoto's, then sent me on to my endo. If I ever did have to have TT, I'd certainly go back to my ENT; he did 2 surgeries on my vocal cords that allow me to talk today, and he does do thyroid removal. It's possible that you might not have had the same issues with an endo, but on the other hand, the wrong endo could have made things 10 times worse.
We all want to help people avoid incompetent treatment; however, I think it's important to get as many facts as possible regarding a person's specific situation.
Hey Barb,
Not disputing that thyroid hormone is the major issue with HRT, I hear that is pretty easy to replace compared to other hormones,
to this day I cannot tolerate any form of HRT from the loss of my ovaries, and still suffer menopause symptoms ten years later, they cause me severe side effects...but when you add the inability to regulate calcium...and add calcium and vitamin D to the regimen, and must get the replacement exactly right and take it three times or more a day...or suffer numbness, muscle spasms, fatigue, bowel issues, etc...
It does get very complicated...and the risk of hypocalcimia with TT, because of damage or scar tissue from the surgery prevents the parathyroids from functioning is up to 15 percent using a general surgeon for the job...the risk reduces to less than one percent when using an endo surgeon, and the Minimally invasive procedure....that's all I am trying to say, if it has to be done, do it right the first time.
I was never referred to an endo because my thyroid levels were always within normal limits, so I was sent round to 24 other docs and specialist, and never sent to the one that could actually help me.
By this point, my feeling is, if you drive a Honda, why go to a Ford dealership for repair, yea, its a car...but operates very differently, and diagnosing the issue is just as hard.....Same difference here when you are talking about endocrine glands....that is a totally different ball game than what a GP is required to learn.
I have been burned...and just want to help others avoid my troubles.....
All the best,
Lori
Not disputing that thyroid hormone is the major issue with HRT, I hear that is pretty easy to replace compared to other hormones,
to this day I cannot tolerate any form of HRT from the loss of my ovaries, and still suffer menopause symptoms ten years later, they cause me severe side effects...but when you add the inability to regulate calcium...and add calcium and vitamin D to the regimen, and must get the replacement exactly right and take it three times or more a day...or suffer numbness, muscle spasms, fatigue, bowel issues, etc...
It does get very complicated...and the risk of hypocalcimia with TT, because of damage or scar tissue from the surgery prevents the parathyroids from functioning is up to 15 percent using a general surgeon for the job...the risk reduces to less than one percent when using an endo surgeon, and the Minimally invasive procedure....that's all I am trying to say, if it has to be done, do it right the first time.
I was never referred to an endo because my thyroid levels were always within normal limits, so I was sent round to 24 other docs and specialist, and never sent to the one that could actually help me.
By this point, my feeling is, if you drive a Honda, why go to a Ford dealership for repair, yea, its a car...but operates very differently, and diagnosing the issue is just as hard.....Same difference here when you are talking about endocrine glands....that is a totally different ball game than what a GP is required to learn.
I have been burned...and just want to help others avoid my troubles.....
All the best,
Lori
COMMUNITY LEADER
I've never had an FNA and I won't dispute anything Lori has said, because I've not had a chance to research any of this. From everything I've ever read, FNA is safe.
I will say that many of us have nodules on our thyroid and they are nothing to worry about.
Thyromegaly: "abnormally enlarged thyroid gland; can result from underproduction or overproduction of hormone or from a deficiency of iodine."
Goiter is an enlarged thyroid and can be caused by several things, most often Thyroiditis (inflammation). Goiter and Thyromegaly are basically the same thing.
Can you post whatever thyroid labs you've had done, along with the reference ranges from your lab report, since these vary from lab to lab.
Have you ever been tested for thyroid antibodies to check for Hashimoto's?
In regards to Lori's comment: "Research the symptoms of hypothyroidism and hypocalciemia....and read how many in this forum are suffering from it as a result of TT Total thyroidectomy. Misery, and swallowing pills will be the rest of your days with these conditions caused by a less than excellent surgery. Loss of voice, nerve damage to the face or shoulder...geesh..so much can go wrong.."
Please be aware that having TT will leave one without the means of producing thyroid hormones (no thyroid, no hormones), and while there are quite a few on this forum who have had TT and are dependent on thyroid hormone replacement for the rest of their life, this is not the worst thing that can happen. I have Hashimoto's Thyroiditis, which has destroyed my thyroid, so it no longer produces thyroid hormones --- I am dependent on thyroid replacement hormones as well.
Yes, there's a lot that can go wrong, these things do not go wrong in the majority of cases ---- there's also a lot that can go right!! With proper testing and treatment, you can get well.
I do disagree that you HAVE to be treated by an endocrinologist. There are many other doctors (pcp, ENT, internist, etc) who can treat you as well. Be aware that many endos specialize in diabetes and are not really good at treating thyroid.
Let's work on figuring out your thyroid status.
I will say that many of us have nodules on our thyroid and they are nothing to worry about.
Thyromegaly: "abnormally enlarged thyroid gland; can result from underproduction or overproduction of hormone or from a deficiency of iodine."
Goiter is an enlarged thyroid and can be caused by several things, most often Thyroiditis (inflammation). Goiter and Thyromegaly are basically the same thing.
Can you post whatever thyroid labs you've had done, along with the reference ranges from your lab report, since these vary from lab to lab.
Have you ever been tested for thyroid antibodies to check for Hashimoto's?
In regards to Lori's comment: "Research the symptoms of hypothyroidism and hypocalciemia....and read how many in this forum are suffering from it as a result of TT Total thyroidectomy. Misery, and swallowing pills will be the rest of your days with these conditions caused by a less than excellent surgery. Loss of voice, nerve damage to the face or shoulder...geesh..so much can go wrong.."
Please be aware that having TT will leave one without the means of producing thyroid hormones (no thyroid, no hormones), and while there are quite a few on this forum who have had TT and are dependent on thyroid hormone replacement for the rest of their life, this is not the worst thing that can happen. I have Hashimoto's Thyroiditis, which has destroyed my thyroid, so it no longer produces thyroid hormones --- I am dependent on thyroid replacement hormones as well.
Yes, there's a lot that can go wrong, these things do not go wrong in the majority of cases ---- there's also a lot that can go right!! With proper testing and treatment, you can get well.
I do disagree that you HAVE to be treated by an endocrinologist. There are many other doctors (pcp, ENT, internist, etc) who can treat you as well. Be aware that many endos specialize in diabetes and are not really good at treating thyroid.
Let's work on figuring out your thyroid status.
Aimee,
If you are concerned with thyroid cancer....ASK for a Calcitonin test, that will pick up the least treatable forms of thyroid cancer in the blood, all the other cancers of the thyroid (4 total) are cured 98 percent of the time very easily, just start eliminating the worse forms first, all by blood tests.. .
Stressing about it will make you sicker, so no worries, redirect your thoughts and actions, be proactive...., if it were cancer, as well, they should be able to see enlarged lymph nodes near the thyroid, from all I have read..., they tell me those can just be removed as well, and that the RAI will cure it just fine.....
I would not worry until those show up. I do have some of those at 1.25 cm left jugular lymph chain, near my "suspicous" nodule...and I was freaking out until I found out how easy it is to cure...so now, I tell myself, no big deal, the light at the end of my very long tunnel is near...and good health will come soon now...
Now, its just the frustration of the wait, transferring records around, waitng for appointments 3-4 weeks apart for each step along the way, since November now, I have know what it is... and arguing with surgeons on the type of surgery that I want, and Exploratory surgery aint it baby...I want the safest and most effective, my sick days are going to be over AND SOON!
Round ONE....Fight!!
ASK for PTH parathyroid hormone, plus calcium levels and D, plus Calcitonin be checked, plus phosphates...This is never a part of the thyroid tests...ever
And of course get the full thyroid panel...all of them....look it up to be sure they order it right and GET COPIES of results!
Remember, you go to a surgeon for advice, surgery is all they do, and surgeons need to make a living too don't forget that....you go to an endocrinologist, and hormones is ALL they do...get to the right docs it is so important, then follow up with the safest most effective experienced surgeons and procedures out there for a no complication cure...big money is made off complications...don't forget that either...not saying they would do it on purpose, all I am saying is avoid it like the plague or dwindle in the health-care system till they sap you dry of everything that used to be you...and your life is ruined...like mine..but
I WILL GET BETTER....I WILL GET BETTER.....AND I WONT GIVE UP TILL I DO!
Sincerely,
Lori
Best article on Goiter....I would not be concerned with cancer on these...and again, the ultra sound is excellent without FNA in determining the characteristics of cancerous nodules. They look different on the scans. I would do as this article recommends:
What I get here about the Goiter is that it is not necessary to remove it unless it gets so big that you cannot swallow or obstructs breathing. Look...more than 40 percent of the population has nodules...benign nodules.
http://www.endocrineweb.com/conditions/thyroid/thyroid-goiter
Try medications (hormone replacement therapy HRT) to control the growth of the goiter, and that means get a REALLY GOOD ENDO...I cannot stress how important that is...
General docs will say they can treat you...but they do NOT have the training, or understanding of Endos. They do one thing...Hormones and the glands that produce them, and will help you attain Homeostasis....optimal cellular function.
The endocrine glands are the GOD factor of all function in every system of the body, they are the chemical messengers that control all function of all organs.
The glands produce hormones...hormones control even brain function and how you feel, love, pain, joy, anger, ..adrenalin is a hormone, activated by thoughts of impending danger...nerve impulses sent from the brain, set of chain reactions in the body, stimulating hormones for any given stituation...
That is why they say CHRONIC STRESS is the NUMBER ONE KILLER OF ALL HUMANS, and even causes up to 70 percent of ALL CANCER from repeated attacks of stress hormones....
The body is not built to endure repeated elevations of stress hormones, Stress hormones are for one thing...to keep you alive in the face of imminent danger..know as the "Fight or Flight response.
The body s not that evolved YET to determine that fear of job loss or an azz in traffic for example, does not require stress hormone activation, we have fear of many things in this life that are not actually life threatening situations...,....but the body cannot differenitate that, because in your little mind...these situations are life threatening, a threat to the way you live it. It was built to help you avoid being eaten by a dinosaur, allowing you to fight for life..or run like the wind!!!
That is why practicing stress reduction techniques are SO IMPORTANT to good health...by stimulating the pleasure and comfort centers of the brain, it shuts down production of the hormones that can kill you with repeated attacks;..
With stress reduction therapies...and you can do it yourself or with a partner for FREE.....good hormones are released...such as endorphins (great ones released with exercise (ever heard the old saying: "idle hands are the devils workshop?"...think about that now:)...gives you that exercise feel good HIGH...) and enkephins....the bodies natural mood simulators and pain killers....
You Can manipulate these types of hormones without drugs... ever seen on TV how people can slow their own hearbeat, change body temperature...all with a thought...yes..it can be done,
The brain is very powerful, and thoughts control how the body responds!!!.. You must be the master of your body by learning how to manipulate how certain situations affect your thoughts.
Know that these overly hyper situations have a very negative effect on your health, every organ in the body. So, next time you get angry...decide is that really worth risking my health over...NO...so let it go, and move on, take a VERY deep breath, so deep your belly rises...make it fat...and let it go,
Change direction in what you are doing, change your thoughts to a complete other subject...look at a leaf...every detail, think of what kind of tree this must be, or not be, wonder if it produces fruit or flowers, is it green year round or does it renew every spring...etc, etc......or any object nearby will work, think of how it was made, who made it, and why....
This is called re-direction of the brain, and it works!
Massage therapy is great for this...walks in nature (or even walking down to the mailbox and back), are great for this...working out even for only 3 minutes are great for this...sex is great for this....Light bulb on yet?
They also control..how fast or slow your heart beats, how healthy your bones are..., they control nerve function, they control muscles, they control digestion...they control hair growth, how healthy your skin is...many rashes are caused by hormone problems...GET IT>.. GOD FACTOR for the body...
They keep you alive and feeling well...or can make you feel like you are dying when they go bad. A tumor on the gland will cause overproduction, or sometimes, under production of the gland, and until that is solved, symptom treating with prescription drugs for pain and fatigue and depression is pointless...OK?
Dont let the nodule thing scare the hell out of you. After exhaustive research and reading...I am at peace with my nodules, and know that they will be checked for cancer when they are removed with my parathyroid adenoma....and the chances are less than 5 percent that I have anything to worrry about, so that I will not waste my worry on, worry makes me sicker in every sense.
I will know soon enough, and if it is...there is a 98 percent chance it will be cured with one radioactive iodine pill, so DONT WORRY....
Another thing that eased my mind, was getting copies of my blood work tests, and looking up what any abnormal values high or low actually means. After balancing all of that, none of my blood work indicates cancer. TSH, FT3 + 4, Calcium, PTH, vitamin D, get a complete metobolic panel, a complete thyoid panel, and ask for PTH, Calcium and vitamin D.
Parathyroid hormone regulates one thing...Calcium. A high calcium value and a high PTH (parthyroid hormone) means one thing....a tumor on the gland causing over production of the hormone, making too much calcium. If Parathyroid hormone is high...that means the body is LOW on calcium...when both are high,,,it is malfunctioning, like a thermostat that will not cut off when it reaches the set temperature.
Also they did a 24 hour calcuim urine test, and abdominal ultrasound....All fine except for high calcium and high PTH with low vitamin D. Your body must have D to be able to absorb the calcium...D responds to the calcuim level in the body...when it is HIGH, D will be LOW to protect you from being killed from the effects of absorbing too much calcium.
If it were cancer, more would be out of whack, and it is not. High calcium and low vitamin D alone will make you feel like you had rather be dead...the depression is horrible along with the pain and fatigue.
I feel like I am coming down with the flu, or have been stuck in a blizzard, come inside, and feel so tired and achey after the thaw...ache all over most days without the respiratory stuff like flu...just warmed over doggie doo!
I knew there was something seriously wrong with me for years...they kept telling me all my labs look fine so its all in my head and I need a psychiatrist. Well did that...all those drugs wound me up in the ER with horrid adverse effects, and nearly killed me once...literally!
So take your pills and shove them BIG PHARMA = BIG LIE and they are only in it for the money of selling more drugs, promising a cure that does not exist for my condition.
Only cure for me...surgical removal of the tumor on my parathyroid gland that is causing it to overproduce PTH, parathyroid hormone. You cant fix a hormone problem with drugs in the parathyroid....but the thyroid is responsive to drug therapies much better.
Good luck all.
Lori
I go to my endocrinologist already and the findings about my ultrasound is a non toxic multinodular thyorid. She advised me to have FNA test but she told me that she has an idea that it is not cancerous but still i am afraid of the FNA because my friend told me that its too painful. And as you've said i have this hypoechoic nolid.. it bothers me alot. I didnt go to pathologist yet to have that FNA test. My doctor even allows me to work.. I dont know what to think now.. i afraid..
so I had an ultra sound done and multi nodular goitre was found.... twelve months ago had FNB and all was clear NO cancer.... phew. This year pressure in my throat and pain, another ultrasound and goitre is growing. What do you suggest now? just leave it alone?
Lori, You certainly have done a lot of work. I like to do research too....just don't know if I have that much energy. I appreciate all of these links so I can really check it out. Wow you have saved us so much time. You have done all the work but have shared with us. Thank You so very much. I am gonna go check some of these out.
Sass
Sass
Here are a few articles to consider, keep in mind, with a cancer diagnosis, there will be more than one surgery most likely, they want you to be able to continue producing hormone from it,
(just like ovaries...if can keep one...best option! HRT is soooo tricky to get right so you feel human and function without pain, numbness and dreadful fatigue...eating problems...many problems...major ones; so they will start with taking half out usually, then they biopsy that half...FNA's have been done on that half, where the "suspicious" nodules were.
Then, two weeks later they will say, that one was positve for papillary cancer so you must have radiation therapy radioactive iodine....this will kill the other half of the thyroid so they must remove it prior to radiation. Then you will be scanned often to look for any other cancer spreading. Of all the blogs I have read...none of the "cancers" found in this way ever come back, and the other half of the thyroid that came out on the second surgery did not have "cancer" in it...it had not had any FNAs on that side ....GET IT?
I can tell you I have watched many you tube blogs from people in this very situation and read many blogs as well, many document for years. Most lose the voice for a year or more...just a whisper left if the larangeal nerve was damaged ....That happens 22 percent of the time on the second surgery, and 4 percent on the first.
Scar tissue builds up....with repeated cuts, even if they managed not to slice it during the surgery...still lose voice. Some say even cell phones will not pick up what they need to say. Good one on you tube is "Not having a Thyroid *****" Link in to her channel, she tells of the problems of regulating meds too.
Read:
"Researchers assess risk of nerve damage in thyroid cancer surgeries"
http://www.endocrineweb.com/news/thyroid-cancer/4489-researchers-assess-risk-nerve-damage-thyroid-cancer-surgeries
AND:
"Incidence of thyroid cancer increases while mortality rate dips, experts say"
http://www.endocrineweb.com/news/papillary-thyroid-cancer/3951-incidence-thyroid-cancer-increases-while-mortality-rate-dips-expe
AND:
The Studies..there are many:
* Case report
"Worrisome histologic alterations following fine-needle aspiration of the parathyroid" (and thyroid).
http://jcp.bmjjournals.com/content/59/10/1094.abstract
Intrathyroidal oncocytic parathyroid adenoma: a diagnostic pitfall on fine-needle aspiration.
http://www.ncbi.nlm.nih.gov/pubmed/20301208
Here is the study with the SHOCKING RESULTS about FNAs I was referring to:..keep in mind...the parathyroids and thyroid are one on top of the other...behind the thyroid gland lies 4 small parathyroid glands...if you watch the surgery of Dr. Norman I was telling you about you will see, they are all right there together....the tissue looks near identical of both glands...put it this way, the normal parathyroid is the size of a grain of rice on the back of the thyroid gland...if tumor (adenoma) is there it can get about the size of a grape or olive.
Find it here: http://www.ncbi.nlm.nih.gov/pubmed/17887929
(By the way, this study was done by the surgeons who will perform my surgery!!)
Thyroid. 2007 Dec;17(12):1251-5.
Diagnostic aspiration of parathyroid adenomas causes severe fibrosis complicating surgery and final histologic diagnosis.
Norman J, Politz D, Browarsky I.
Norman Endocrine Surgery Clinic, Tampa, Florida 33613, USA. ***@****
Comment in:
* Thyroid. 2008 May;18(5):581-2; author reply 583-4.
Abstract
OBJECTIVE: To determine whether fine-needle aspiration (FNA) of parathyroid adenomas may cause a severe fibrotic reaction of the gland and surrounding structures, making surgery more difficult and histology more confusing.
DESIGN: A study was conducted over a 33-month period to compare the operative findings of 30 patients who underwent FNA of a parathyroid adenoma to those of 3000 patients who had not had their parathyroid tumor aspirated. Each patient's normal parathyroid glands also served as internal controls. All aspirations were performed by referring physicians under direct ultrasound guidance within 3 months of surgery, and all adenomas were located in routine positions. Patients who had previous thyroid or parathyroid surgery were not included. Patients with secondary or tertiary hyperparathyroidism were not included.
MAIN OUTCOME: The control group (non-FNA) showed a fibrotic reaction in 127 (4.3%) tumors appreciated by the surgeon and recognized on histology. In contrast, tumors undergoing FNA had a dense and often severely fibrotic reaction seen at surgery in 19 of 30 (63%) (p < 0.0001) and on histology in 23 of 30 (77%) (p < 0.0001). The fibrotic reaction appeared to mimic malignancy on histology and increased in occurrence with increased numbers of aspiration passes and larger needle bore (p 7500) or hyperplastic glands (n = 488) demonstrated fibrosis in any patient. Tumors that were aspirated required an eightfold increase in time to remove (p < 0.005) and more than doubled the total operative time (p < 0.05).
CONCLUSIONS: FNA of parathyroid adenomas can cause a severe fibrotic process that typically involves adjacent tissues. This reaction dramatically increases the difficulty of surgical resection, often requiring microdissection techniques to preserve nerves and assure complete removal. The fibrosis can cause confusing histology mimicking malignancy. FNA of parathyroid adenomas should be avoided unless absolutely necessary.
PMID: 17887929 [PubMed - indexed for MEDLINE]
Publication Types, MeSH Terms
Publication Types:
* Controlled Clinical Trial
MeSH Terms:
* Adenoma/diagnosis*
* Adenoma/pathology
* Adenoma/surgery*
* Biopsy, Fine-Needle/adverse effects*
* Diagnosis, Differential
* Fibrosis/diagnosis
* Fibrosis/etiology
* Fibrosis/pathology
* Humans
* Parathyroid Glands/pathology
* Parathyroid Glands/surgery
* Parathyroid Neoplasms/diagnosis*
* Parathyroid Neoplasms/pathology
* Parathyroid Neoplasms/surgery*
* Parathyroidectomy
LinkOut - more resources
There are more, I'm tired...hope this helps someone besides me!! Now you know where to find this cool stuff...enjoy.
Best wishes for a great outcome all...remember it is up to you to question, and learn...dont be a lamb and just roll over at what ever they want to do to you...it is YOUR LIFE...live it well in health!
Lori
PS: The video link for the M I R P used for thyroid issues too!! 99.8 percent CURE rate...one procedure, your done with the Norman Parathyroid Center
http://orlive.com/videos/minimally-invasive-parathyroid-surgery/SHOWDRAFT/1/FLUSHCACHE/1
From this site:
http://parathyroid.com/
(just like ovaries...if can keep one...best option! HRT is soooo tricky to get right so you feel human and function without pain, numbness and dreadful fatigue...eating problems...many problems...major ones; so they will start with taking half out usually, then they biopsy that half...FNA's have been done on that half, where the "suspicious" nodules were.
Then, two weeks later they will say, that one was positve for papillary cancer so you must have radiation therapy radioactive iodine....this will kill the other half of the thyroid so they must remove it prior to radiation. Then you will be scanned often to look for any other cancer spreading. Of all the blogs I have read...none of the "cancers" found in this way ever come back, and the other half of the thyroid that came out on the second surgery did not have "cancer" in it...it had not had any FNAs on that side ....GET IT?
I can tell you I have watched many you tube blogs from people in this very situation and read many blogs as well, many document for years. Most lose the voice for a year or more...just a whisper left if the larangeal nerve was damaged ....That happens 22 percent of the time on the second surgery, and 4 percent on the first.
Scar tissue builds up....with repeated cuts, even if they managed not to slice it during the surgery...still lose voice. Some say even cell phones will not pick up what they need to say. Good one on you tube is "Not having a Thyroid *****" Link in to her channel, she tells of the problems of regulating meds too.
Read:
"Researchers assess risk of nerve damage in thyroid cancer surgeries"
http://www.endocrineweb.com/news/thyroid-cancer/4489-researchers-assess-risk-nerve-damage-thyroid-cancer-surgeries
AND:
"Incidence of thyroid cancer increases while mortality rate dips, experts say"
http://www.endocrineweb.com/news/papillary-thyroid-cancer/3951-incidence-thyroid-cancer-increases-while-mortality-rate-dips-expe
AND:
The Studies..there are many:
* Case report
"Worrisome histologic alterations following fine-needle aspiration of the parathyroid" (and thyroid).
http://jcp.bmjjournals.com/content/59/10/1094.abstract
Intrathyroidal oncocytic parathyroid adenoma: a diagnostic pitfall on fine-needle aspiration.
http://www.ncbi.nlm.nih.gov/pubmed/20301208
Here is the study with the SHOCKING RESULTS about FNAs I was referring to:..keep in mind...the parathyroids and thyroid are one on top of the other...behind the thyroid gland lies 4 small parathyroid glands...if you watch the surgery of Dr. Norman I was telling you about you will see, they are all right there together....the tissue looks near identical of both glands...put it this way, the normal parathyroid is the size of a grain of rice on the back of the thyroid gland...if tumor (adenoma) is there it can get about the size of a grape or olive.
Find it here: http://www.ncbi.nlm.nih.gov/pubmed/17887929
(By the way, this study was done by the surgeons who will perform my surgery!!)
Thyroid. 2007 Dec;17(12):1251-5.
Diagnostic aspiration of parathyroid adenomas causes severe fibrosis complicating surgery and final histologic diagnosis.
Norman J, Politz D, Browarsky I.
Norman Endocrine Surgery Clinic, Tampa, Florida 33613, USA. ***@****
Comment in:
* Thyroid. 2008 May;18(5):581-2; author reply 583-4.
Abstract
OBJECTIVE: To determine whether fine-needle aspiration (FNA) of parathyroid adenomas may cause a severe fibrotic reaction of the gland and surrounding structures, making surgery more difficult and histology more confusing.
DESIGN: A study was conducted over a 33-month period to compare the operative findings of 30 patients who underwent FNA of a parathyroid adenoma to those of 3000 patients who had not had their parathyroid tumor aspirated. Each patient's normal parathyroid glands also served as internal controls. All aspirations were performed by referring physicians under direct ultrasound guidance within 3 months of surgery, and all adenomas were located in routine positions. Patients who had previous thyroid or parathyroid surgery were not included. Patients with secondary or tertiary hyperparathyroidism were not included.
MAIN OUTCOME: The control group (non-FNA) showed a fibrotic reaction in 127 (4.3%) tumors appreciated by the surgeon and recognized on histology. In contrast, tumors undergoing FNA had a dense and often severely fibrotic reaction seen at surgery in 19 of 30 (63%) (p < 0.0001) and on histology in 23 of 30 (77%) (p < 0.0001). The fibrotic reaction appeared to mimic malignancy on histology and increased in occurrence with increased numbers of aspiration passes and larger needle bore (p 7500) or hyperplastic glands (n = 488) demonstrated fibrosis in any patient. Tumors that were aspirated required an eightfold increase in time to remove (p < 0.005) and more than doubled the total operative time (p < 0.05).
CONCLUSIONS: FNA of parathyroid adenomas can cause a severe fibrotic process that typically involves adjacent tissues. This reaction dramatically increases the difficulty of surgical resection, often requiring microdissection techniques to preserve nerves and assure complete removal. The fibrosis can cause confusing histology mimicking malignancy. FNA of parathyroid adenomas should be avoided unless absolutely necessary.
PMID: 17887929 [PubMed - indexed for MEDLINE]
Publication Types, MeSH Terms
Publication Types:
* Controlled Clinical Trial
MeSH Terms:
* Adenoma/diagnosis*
* Adenoma/pathology
* Adenoma/surgery*
* Biopsy, Fine-Needle/adverse effects*
* Diagnosis, Differential
* Fibrosis/diagnosis
* Fibrosis/etiology
* Fibrosis/pathology
* Humans
* Parathyroid Glands/pathology
* Parathyroid Glands/surgery
* Parathyroid Neoplasms/diagnosis*
* Parathyroid Neoplasms/pathology
* Parathyroid Neoplasms/surgery*
* Parathyroidectomy
LinkOut - more resources
There are more, I'm tired...hope this helps someone besides me!! Now you know where to find this cool stuff...enjoy.
Best wishes for a great outcome all...remember it is up to you to question, and learn...dont be a lamb and just roll over at what ever they want to do to you...it is YOUR LIFE...live it well in health!
Lori
PS: The video link for the M I R P used for thyroid issues too!! 99.8 percent CURE rate...one procedure, your done with the Norman Parathyroid Center
http://orlive.com/videos/minimally-invasive-parathyroid-surgery/SHOWDRAFT/1/FLUSHCACHE/1
From this site:
http://parathyroid.com/
I wasnt getting down on you Sassy, Hell, even the ultrasound techs claim to have never heard of these studies, and as they told me...we do FNA's all day long...this was at the VA, Veterans Hospital.
Latest study was performed using data from the Veterans hospitals..."Thyroid Cancer diagnosis up...Mortality down.... 2 percent. News article, Google it, and put two and two together, the FNA studies and this data! Scary stuff, and I wonder how many have been misdiagnosed?....
Probably they are all un-insurable now too! Life changer....all over a needle. Much to consider here!
When they say this is one of the most curable cancers to have, and you are lucky....I say, poor people that have to go through all that surgery, and complications for nothing all caused by the scars left by FNA....seriously, no wonder its the most curable, they probably never had it in the first place!
I am having the MIRP, Minimally Invasive Radioguided Proceedure, where they take of the thryoid, the nodules, and my bad parathyroid adnemona all at the same time....20 min outpatient procedure!! I have to go to Tampa for that, but hey, get it done right the first time.
They will not even take you as a patient if you have had FNA with a larger needle, over a certain size...and charge nearly twice as much if this is your second surgery to get done what the first missed, or scrwed up.
Go to www.parathyroid.com These patients are CURED the first time and never have to do it over and over, or be misdiagnosed with cancer! Dr. Normans videos are great too.
There is one of the actual surgery, with a 10 minute into all about these diseases and nodules. I know there is a link to the movie on the become a patient page, all the way at the bottom. IMPRESSIVE> to him, nodules are absolutely no big deal at all...nothing to stress over, 98 percent benign I think are the numbers....my memory is bad though...I am a sickie too!!!
Lori
Latest study was performed using data from the Veterans hospitals..."Thyroid Cancer diagnosis up...Mortality down.... 2 percent. News article, Google it, and put two and two together, the FNA studies and this data! Scary stuff, and I wonder how many have been misdiagnosed?....
Probably they are all un-insurable now too! Life changer....all over a needle. Much to consider here!
When they say this is one of the most curable cancers to have, and you are lucky....I say, poor people that have to go through all that surgery, and complications for nothing all caused by the scars left by FNA....seriously, no wonder its the most curable, they probably never had it in the first place!
I am having the MIRP, Minimally Invasive Radioguided Proceedure, where they take of the thryoid, the nodules, and my bad parathyroid adnemona all at the same time....20 min outpatient procedure!! I have to go to Tampa for that, but hey, get it done right the first time.
They will not even take you as a patient if you have had FNA with a larger needle, over a certain size...and charge nearly twice as much if this is your second surgery to get done what the first missed, or scrwed up.
Go to www.parathyroid.com These patients are CURED the first time and never have to do it over and over, or be misdiagnosed with cancer! Dr. Normans videos are great too.
There is one of the actual surgery, with a 10 minute into all about these diseases and nodules. I know there is a link to the movie on the become a patient page, all the way at the bottom. IMPRESSIVE> to him, nodules are absolutely no big deal at all...nothing to stress over, 98 percent benign I think are the numbers....my memory is bad though...I am a sickie too!!!
Lori
Okay, sorry I did not know all this. Guess I should not have shared this info with you Aimee and believe me I would not ever suggest to tell you what to do. I was hoping to get you a little info on your results as I had noticed that no one had responded to your post. The information I had posted was from a thyroid specialist. I am awaiting my ultrasound and biopsy as well.
But I do know personally that 15 years ago, my father had a Total thyroidectomy due to cancer and yes, he is on a lifetime regime of thyroid medication (1 pill daily) and he has 100% had no type of complication due to the removal. He is now 84. He has routine bloodwork done reguarly and has been balanced with no major changes in meds for at least 10 years.
I will take the advice of bama and do some further research on FNA as I was not aware of all these risks. A good friend of mine has had it done on her thyroid and has never mentioned any of these problems.
I wish you the very best and will pray that all works out well for you.
But I do know personally that 15 years ago, my father had a Total thyroidectomy due to cancer and yes, he is on a lifetime regime of thyroid medication (1 pill daily) and he has 100% had no type of complication due to the removal. He is now 84. He has routine bloodwork done reguarly and has been balanced with no major changes in meds for at least 10 years.
I will take the advice of bama and do some further research on FNA as I was not aware of all these risks. A good friend of mine has had it done on her thyroid and has never mentioned any of these problems.
I wish you the very best and will pray that all works out well for you.
Yea...about the FNA...over used.
The needle can cause scar tissue on the thyroid, and is hard to get a diagnosis using FNA anyhow....results inconclusive so many times, then partial thyroidectomy is recommended with that result.
A lobe or part of the thyroid is then removed, the part they have done the FNA on now has scar tissue from the needle...they will not only stick you once to get this done, but multiple times...now...when the pathologist looks at the gland with the scar tissue, the scarring looks just like cancer cells under the scope...so, then they tell you that you must have the rest of thyroid removed and undergo radiation, and suffer with now possible life long symptom management of no thyroid and probable damage to parathroids during the thyroid surgery.
Research the symptoms of hypothyroidism and hypocalciemia....and read how many in this forum are suffering from it as a result of TT Total thyroidectomy. Misery, and swallowing pills will be the rest of your days with these conditions caused by a less than excellent surgery. Loss of voice, nerve damage to the face or shoulder...geesh..so much can go wrong...
As I have found, I am my ONLY advocate, and if I dont ask the questions, no one will.
They can tell by looking at the characteristics of the nodules if they need to be removed or not.
If you dont want to be diagnosed with cancer, or have unnecessary surgery, and the nodules are recommended for removal...best thing to do is have a frozen section of the nodule done DURING surgery. This way, if not cancer, you get to keep your glands in tact and your life is not ruined.
Go to PUBMED and look up the studies on FNA and parathryoid and thyroid. Only 5 percent of people who did not have FNA actually had cancer VS 74 percent of those who had FNA prior to surgery and upon biopsy of glands post surgery...now be safe, not sorry.
Trust me getting your hormones screwed up for the rest of your life will make you wish you were dead already, be careful and research it. Cancer is BIG business, make it your business to do what is right for YOU> not what someone tells you.
The needle can cause scar tissue on the thyroid, and is hard to get a diagnosis using FNA anyhow....results inconclusive so many times, then partial thyroidectomy is recommended with that result.
A lobe or part of the thyroid is then removed, the part they have done the FNA on now has scar tissue from the needle...they will not only stick you once to get this done, but multiple times...now...when the pathologist looks at the gland with the scar tissue, the scarring looks just like cancer cells under the scope...so, then they tell you that you must have the rest of thyroid removed and undergo radiation, and suffer with now possible life long symptom management of no thyroid and probable damage to parathroids during the thyroid surgery.
Research the symptoms of hypothyroidism and hypocalciemia....and read how many in this forum are suffering from it as a result of TT Total thyroidectomy. Misery, and swallowing pills will be the rest of your days with these conditions caused by a less than excellent surgery. Loss of voice, nerve damage to the face or shoulder...geesh..so much can go wrong...
As I have found, I am my ONLY advocate, and if I dont ask the questions, no one will.
They can tell by looking at the characteristics of the nodules if they need to be removed or not.
If you dont want to be diagnosed with cancer, or have unnecessary surgery, and the nodules are recommended for removal...best thing to do is have a frozen section of the nodule done DURING surgery. This way, if not cancer, you get to keep your glands in tact and your life is not ruined.
Go to PUBMED and look up the studies on FNA and parathryoid and thyroid. Only 5 percent of people who did not have FNA actually had cancer VS 74 percent of those who had FNA prior to surgery and upon biopsy of glands post surgery...now be safe, not sorry.
Trust me getting your hormones screwed up for the rest of your life will make you wish you were dead already, be careful and research it. Cancer is BIG business, make it your business to do what is right for YOU> not what someone tells you.
Thyroid nodules are very common — it is estimated that 20 to 40 percent of the population has them. They are nearly always benign (not cancerous). The goal of the physician, once a thyroid nodule has been detected, is to determine whether the nodule should be further evaluated to rule out cancer. A sonogram (ultrasound) of the thyroid gland is one of the best tests to evaluate thyroid nodules. When radiologists read the sonogram to look at specific features of the nodules, hypoechoic and hyperechoic are terms they use to describe what sort of echo "shadow" the nodule casts. Hypoechoic nodules cast off fewer or weaker echoes than the surrounding normal tissue, while hyperechoic nodules cast more or stronger echoes than the surrounding normal tissue.
Typically, benign thyroid nodules appear hyperechoic on the sonogram, while malignant (cancerous) thyroid nodules are more likely to be hypoechoic, casting off fewer or weaker echoes. However, the chance of any hypoechoic nodule being cancerous is still very low, because benign thyroid nodules are much more common. If a thyroid nodule requires further evaluation, the next step is generally to perform a fine needle aspiration (FNA) of the suspicious nodule, a test in which a thin needle is inserted into the nodule to extract cells for evaluation. Looking at these cells under a microscope helps to determine whether or not the nodule contains cancer cells.
Bottom line: You should speak with your doctor about your thyroid ultrasound results and ask whether the findings require further evaluation by a test such as an FNA.
Aimee, this is some info i found for you and pasted. The other information I found about the thickening of the isthmus can be just a goiter, That is what we will hope. good Luck and keep us posted !! Sass
Typically, benign thyroid nodules appear hyperechoic on the sonogram, while malignant (cancerous) thyroid nodules are more likely to be hypoechoic, casting off fewer or weaker echoes. However, the chance of any hypoechoic nodule being cancerous is still very low, because benign thyroid nodules are much more common. If a thyroid nodule requires further evaluation, the next step is generally to perform a fine needle aspiration (FNA) of the suspicious nodule, a test in which a thin needle is inserted into the nodule to extract cells for evaluation. Looking at these cells under a microscope helps to determine whether or not the nodule contains cancer cells.
Bottom line: You should speak with your doctor about your thyroid ultrasound results and ask whether the findings require further evaluation by a test such as an FNA.
Aimee, this is some info i found for you and pasted. The other information I found about the thickening of the isthmus can be just a goiter, That is what we will hope. good Luck and keep us posted !! Sass
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