# Cysts? Nodules? Hashi's and hyperfunctioning? WHAT!?



## Mdithrich (Sep 26, 2013)

I just received my lab results from my ultrasound and reuptake test but I really don't understand them and I'm hoping that someone out there can make sense of them?

Clinical Findings: Abnormal thyroid laboratory measurements

Findings: The right lobe measures 5.7 x 1.6 x 2.1 cm for a volume of 10.3 cc. The left lobe measures 4.7 x 1.3 x 2.2 cm for a volume of 7 cc. Within the midportion right lobe is a 4.5 mm cyst with mural nodule consistent with a colloid cyst. The gland shows a coarsened echogenicity. It is diffusely hypervascular. Below the thyroid gland there are multiple hypoechoic solid nodules, some of which have central bright echoes likely lymphadenopathy. CT soft tissue neck contrast study follow up recommended.

Impression: Coarsening of the echo architecture diffusely in the thyroid gland with diffuse hyperemia. This type of appearnace can be seen with the Hashimoto's Thyroiditis and should be correlated clinically. There is a small colloid cyst in the right lobe. Suggestion for multiple lymph nodes within the neck below the thyroid gland. CT neck followed recommended.

Reuptake:

Result: Thyroid reuptake and scan demonstrates an enlarged gland hyperfunctioning 49% uptake without cold nodule or hyperfunctioning defect.

Impression: Overall markedly increased function both lobes of the gland, consistent with hyperfunctioning goiter.

Ok....so my question....what the heck does all of this mean? And how can I be showing Hashimoto's with a hyperfunctioning goiter? I don't get this, my doctor basically said, I don't know what's wrong with you, go see an endocrinologist (He was an ENT) and so now I'm back to square one?


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## Prudence (Oct 30, 2012)

You can have both Graves' and Hashi's at the same time, I'm afraid. You also might be in a hyper state right now due to the goiter. Hopefully you can find a good endocrinologist to get into quick.


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## Andros (Aug 26, 2009)

Mdithrich said:


> I just received my lab results from my ultrasound and reuptake test but I really don't understand them and I'm hoping that someone out there can make sense of them?
> 
> Clinical Findings: Abnormal thyroid laboratory measurements
> 
> ...


Have you had the solid nodules biopsied? Solid and vascular are 2 words that strongly suggest cancer. Also, the hyperfunctioning is often caused by cancer.

For this reason, I strongly suggest you see either another ENT or Doctor who is in the "know!"

The only true test for Hashi's is FNA whereupon the pathologist identifies Hurthle cells indigenous to Hashi's. However, Hashi's patients have been known to go through a hyper period.

They do recommend a CT but ...................................; it may be prudent to just have it out. Save a lot of money and angst that way.

Let us know if you turn up any further information or confirmation.


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## Mdithrich (Sep 26, 2013)

Thank you so much for your input, you have no idea how nice it is (or maybe you do) to talk to someone with knowledge and have gone through the frustration of figuring things out. I'm going to an Endocrinologist on the 6th and in the meantime I sent everything to my friends dad (a convenient ENT but not in my area) for a second opinion.

I haven't had the nodules biopsied, I'm guessing the endocrinologist will want to do that? Maybe? I feel like I wasted time with this doctor as his diagnosis was...."I don't know what's wrong with you" He then hands me my results and tells me to go see an endocrinologist and figure this out. Umm thanks buddy. lol At least we're getting closer. Upbeat attitude right?!


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## Andros (Aug 26, 2009)

Mdithrich said:


> Thank you so much for your input, you have no idea how nice it is (or maybe you do) to talk to someone with knowledge and have gone through the frustration of figuring things out. I'm going to an Endocrinologist on the 6th and in the meantime I sent everything to my friends dad (a convenient ENT but not in my area) for a second opinion.
> 
> I haven't had the nodules biopsied, I'm guessing the endocrinologist will want to do that? Maybe? I feel like I wasted time with this doctor as his diagnosis was...."I don't know what's wrong with you" He then hands me my results and tells me to go see an endocrinologist and figure this out. Umm thanks buddy. lol At least we're getting closer. Upbeat attitude right?!


I do, I do!! Now I am passing it forward and you are very very welcome. If any of us here can be helpful and supportive, I am sure they will do so.

Glad you have a second opinion from a friend's Dad. Let us know.

In the meantime; I forgot to give you some info.

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis

Hashimoto's Hurthle cells
http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)71549-2

http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/

http://www.mayoclinic.com/health/hurthle-cell-cancer/DS00660

http://www.ncbi.nlm.nih.gov/pubmed/12876418
The above on hyper and cancer was rare in 2003 but not so rare now. Probably due to better diagnostics or poorer environmental factors or both.

Thyroid nodules w/flow chart
http://www.aafp.org/afp/2003/0201/p559.html


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## Mdithrich (Sep 26, 2013)

Thank you Andros!!! I'll definitely be taking a look at those links when I get home tonight!


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## Mdithrich (Sep 26, 2013)

So these lumps keep appearing on random parts of my body. They stay for a day or two and then slowly recede. Thoughts on what they are? I'm guessing lymph nodes but I have no idea. Anyone else experience this?

http://s945.photobucket.com/user/missydithrich/library/


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