# Ultrasound Results



## Shelly3054 (Jul 21, 2011)

I'm new so I'll give you a little background. I have been not feeling well for about 2 years. My dr did a blood work for my thyroid then and it came back normal:

T3 - normal
TSH = 1.24

My glucose was off a little fasting 120 so he put me on metformin and gave me something for acid reflux and sent me to a sleep dr for sleep apnea. I was dx with sleep apnea and put on a bipap machine.

All along I have complaining about my throat being squeezed and he kept telling me its acid reflux.

I went for my check up last week and he agreed to run thyroid again and he finally felt my neck and said my thyroid felt lumpy to him so I should have an ultrasound.

Blood work, again T3 normal, TSH = 1.94

Results of ultrasound I picked up today but haven't heard from my drs office yet.

It reads: The right thyroid lobe is fairly homogeneous. There is a small hypoechoic area in the upper pole that measures 7mm in max diameter. In the mid zone there is a 2mm hypoechoic area. In the medial right thyroid isthmus region there is an 8mm hypoechoic area. The right lobe itself measures 4.2 x 1.5 x 1.6 cm.

The left lobe measures 3.9 x 1.4 x 1.7 cm and contains a small hypoechoic area in the mid zone measure about 1.1 cm max diameter.

Also note there is an enlarged right cervical lymph noe measures 3 x .9 x 1 cm.

Recommendation: repeat sonogram in 6 months.

When my dr calls, what do you think I should ask for?


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## Andros (Aug 26, 2009)

Shelly3054 said:


> I'm new so I'll give you a little background. I have been not feeling well for about 2 years. My dr did a blood work for my thyroid then and it came back normal:
> 
> T3 - normal
> TSH = 1.24
> ...


Welcome!

Well, your thyroid is not healthy, that is for sure!! My immediate concern would be the lymph node. I would request FNA (fine needle aspiration) of that. I would not let it go 6 months.

I also don't understand why your doctor ran only TSH and T3. T3 consists of bound, unbound and reverse (rT3) hormone.

You would benefit greatly from having FREE T4 and FREE T3 run.

Here is info on that.

understanding thyroid labs
http://www.amarillomed.com/howto/#Thyroid

http://pro2services.com/Lectures/Spring/Thyroid/ThyTests.htm

Free T3 etc. 
http://www.thyroid-info.com/articles/freet3woliner.htm

And truly, your doc should run these antibodies and immunoglobulins as well.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

A hypoechoic nodule is a fluid-filled or solid mass that casts limited, weakened echoes than surrounding tissue during the administration of an ultrasound, or sonogram. Though this type of mass may be found in any part of the body, it is most frequently detected in the thyroid. Due to the characteristics of its composition, suspicion of malignancy may arise upon the discovery of a hypoechoic nodule prompting additional testing and biopsy. Treatment for a hypoechoic thyroid nodule is dependent on its type, composition, and the overall health of the individual.

http://radiographics.rsna.org/content/27/3/847.full

It is my humble opinion that you do need the FNA. 
New york papillary cancer
http://www.cumc.columbia.edu/dept/thyroid/papillary.html


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## Shelly3054 (Jul 21, 2011)

Andros:

Thank you for your advice.

Since it is my PC dr doing the tests, if I wanted to be sent to a specialist for this, what dr would it be - a ENT dr or an endrocrinologist?

Thanks.


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## Shelly3054 (Jul 21, 2011)

Oh and by the way Andros, your most humble opinion is so welcomed.


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## webster2 (May 19, 2011)

Hi! I would request an FNA sooner rather than later. JMHO.


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## Andros (Aug 26, 2009)

Shelly3054 said:


> Andros:
> 
> Thank you for your advice.
> 
> ...


Shelly; I personally think an ENT would be the person to see about this and I would have the utra-sound results sent over to him or her right away once you chose one.

Endo's seem to specialize in diabetes. I have nothing against that; diabetics are important people too!

Let us know what you decide.


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## Shelly3054 (Jul 21, 2011)

Just got a call from the nurse at my PC dr office.

She said the Ultrasound shows a small cyst and the dr recommends having another ultrasound in 6 months.

Of course they don't know I picked up a copy of the report. No where on the report does it mention a "cyst" and the nurse never mentioned the enlarged right cervical lymph node.

I told her I wasn't comfortable waiting 6 months and I would like to see a ENT specialist. She said she would call me back.

Thank goodness my insurance does not require a referral slip from my PC physician.


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## Andros (Aug 26, 2009)

Shelly3054 said:


> Just got a call from the nurse at my PC dr office.
> 
> She said the Ultrasound shows a small cyst and the dr recommends having another ultrasound in 6 months.
> 
> ...


And thank goodness you are a little aggressive. Good for you and good for you for carefully reading your report!!

Proactive; you go girl!! Yay!

No sheep here!!! Ha, ha!! I love it!

Let us know what happens. If you have anything to do with it, it is gonna' happen!


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## Shelly3054 (Jul 21, 2011)

My dr's ofc called back and he would like me to come in. So I am going in on Thursday to discuss the u/s and my wanting to see a specialist. I don't think he wants me to see a specialist. I am also going to ask him to run all those additional blood tests. I do have one question for anyone who has been through this -- my report says hypoechoic areas (see above) and not until the final sentence does the radiologist say small bilateral thyroid NODULES. So are the hypoechoic areas the nodules?


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## Andros (Aug 26, 2009)

Shelly3054 said:


> My dr's ofc called back and he would like me to come in. So I am going in on Thursday to discuss the u/s and my wanting to see a specialist. I don't think he wants me to see a specialist. I am also going to ask him to run all those additional blood tests. I do have one question for anyone who has been through this -- my report says hypoechoic areas (see above) and not until the final sentence does the radiologist say small bilateral thyroid NODULES. So are the hypoechoic areas the nodules?


it would seem so because hypoechoic (nodules if you will) means the echoes are sluggish if at all meaning solid. That is my interpretation. I could be way off base though.

Most usually, hypoechoic nodules are benign but I think FNA would be recommended.


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