# Ultrasound results. Going out of my mind waiting for my biopsy



## 5hk8 (Aug 20, 2013)

Hi everyone,

I'm a fit and otherwise healthy 29 year old female. My doctor noticed a lump in my thyroid during my physical, so I was sent for an ultrasound last month. I then got referred to an endocrinologist last week. While my endo sounded unphased and unworried by the ultrasound results (he kept insisting that the chance of cancer is low and that I shouldn't lose sleep over it), I have to get a biopsy done of one "suspicious" cyst on my thyroid. My appointment isn't for another 3 months, and I'm driving myself sick with worry in the meantime.

My ultrasound results are below. I don't understand what the difference is between "complex cystic lesions" and "complex cystic mass". I was told that only one of my cysts was complex (the suspicious one), but it sounds like all of them are?

I'm not looking for a diagnosis, just words of comfort which might give me some peace of mind (or at least set me straight for what to expect).

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The right lobe measures 4.2cm in length. The left lobe measures 3.9 cm in length. Multiple complex cystic lesions are seen in the thyroid gland. In the right lobe this includes a 6 mm septated mid pole, mid pole 3 mm and an upper pole 5 mm cyst with internal echogenic nodules. Additional smaller cysts all less than 4 flrm are present in the mid right lobe. In the left sided isthmus there is a complex 1.1 cm cystic mass with echogenic solid nodular component. In the mid pole left lobe there is a 4 mm and a 6mm cyst with internal echogenic nodule and other smaller some cysts in the left lobe.

OPINION: Multiple cystic complex nodules in thyroid gland. These predominantly have the appearance very typical of that of colloid cysts. There is only one atypical nodule in the left sided isthmus with a solid echogenic component. While this could also represent a colloid cyst, the solid
component is not as bright as typically seen with this diagnosis and both benign and malignant etiologies would be consideration for this finding.


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## joplin1975 (Jul 21, 2011)

Ok, first, take a few breaths.  Let's say its the worse case scenario and you have cancer. What does that mean? It means some surgery and follow up care which, yes, is a pain in the neck (pun intended!)...but the vast majority (like, 95%) go on to lead very normal, very full lives. So, the take home message is: it is going to be ok.

With that said, my understanding is the lesion is used to describe any abnormal tissue whereas mass is used for a larger "lump" of tissue...meaning, both are abnormal tissue, but the "mass" is a big larger and more well-defined.

Did you have any blood work done when you went to see the endo? You thyroid sounds very much like an unhealthy gland that has been attacked by autoimmune antibodies. Those of us with autoimmune disease have "lumpy" thyroids.

With thyroid nodules, the general rule of thumb is that anything over 1cm should be biopsied. Especially if there are any solid components to it...so I'm glad you are getting that done. I don't know why they have you waiting three months...that seems a little crazy. You could try to call around and see if anyone else can get you in sooner...

Everyone's biopsy experience has been different. I think it really depends on where the nodule(s) is/are...mine were right on the surface and easy to find. So they didn't use an ultrasound and just poked me quickly five times. I only felt the first poke. 

You'll find a lot of posts on this forum about indeterminate results from a biopsy. Its a real possibility so I think getting blood work so you have as much information as possible is a very good step.


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## Velcro (Jul 26, 2013)

Hang in there. I agree with Joplin that 3 months for the first FNA is a long wait, but take comfort that even IF (and that's a big IF) it was cancer, it is so slow growing and very treatable.

Nodules can be filled with fluid, solid or both. They call them complex when they have both fluid and solid parts.


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## 5hk8 (Aug 20, 2013)

Joplin1975: My blood tests showed no abnormalities with my thyroid levels at all, so I'm even more worried/confused.

I don't know if this is related at all, but I have a lot of benign cysts (fibroadenomas to be exact) in my breasts, and have 2 small, partly-swollen lymph nodes in my neck. All of these have been monitored by ultrasound for the past 6-7 years without problems. My endo also confirmed that my swollen lymph nodes were unrelated to the cysts on my thyroid. The only diagnosis I've received for these lumps is that I'm "just a lumpy person".

Thanks so much for the replies so far  I live in Toronto and the wait time is, on average, 3 months for biopsies. I've called around and found a place that will do it next week in Montreal. So I might have to go there...because no matter how you see it, 3 months is a long time to be like this.


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## joplin1975 (Jul 21, 2011)

5hk8 said:


> Joplin1975: My blood tests showed no abnormalities with my thyroid levels at all, so I'm even more worried/confused.


If you have copies of the results, with the ranges, please post them. Some times normal isn't always normal. I'd be particularly interested to know if antibodies were tested?


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## 5hk8 (Aug 20, 2013)

Joplin: I don't have a copy of my blood test results. My endo was referring to my blood test that was done during my physical, which was about 2 months ago. I'm not sure what my doctor tested for exactly. Should I ask for another blood test?

Also: if I have an autoimmune disease, would I not have symptoms of hypo or hyperthyroidism? Or would I have other worrying symptoms too?


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## joplin1975 (Jul 21, 2011)

I would ask for copies of the results first, let us have a look at them, and then go from there.

Some folks don't have very strong symptoms of autoimmune disease. Of, some people, like me, aren't self-aware enough to realize that the changes we are/were experiencing are not due to something like aging, but rather to autoimmune stuff. These things creep up on you, so it's hard to identify.


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## 5hk8 (Aug 20, 2013)

Hmm ok. Thanks Joplin and Velcro, you've both been very insightful and I feel a bit better now. I'll be back and post what I find out


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## StormFinch (Nov 16, 2012)

Joplin's right. Throughout my 20s I had no idea that the heart rate of 100+, inability to gain weight, subnormal body temp or being "high strung" were anything more than just normal for me. All the doctors I saw commented on how great is was that I had a high metabolism, and although they would do a double take at my heart rate my blood pressure has always ran at least 10 to 20 points below normal so they shrugged it off. It wasn't until almost 20 years later, when my symptoms became more overt, that I ended up with more diagnoses than I cared to have.


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