# Blood work and ultrasound questions



## Christys3 (Nov 2, 2016)

Hi! I am new here and have so questions. 
1) Does a tpo of 54 automatically mean a diagnosis of hashimotos? Does the fact that my tpo is above the threshold, but still low increase the likelihood there is cancer?

2) Can the US be correct? During all of my online research, I have not heard of an 8.6 cm nodule. Does anyone have experience with a nodule of this size? What was the outcome and does a nodule of this size automatically lend itself to surgery?

I was referred to an endo. 
So thankful for any help!


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## Octavia (Aug 1, 2011)

Hi there, and welcome!

Could you please edit your post to include your lab's ranges for the results you've shared? Different labs have different ranges, and that's an important piece of the puzzle. Ranges are often in parentheses next to your results.

If your nodule is 8.6 cm, that's absolutely the largest nodule I've ever heard of. Please double-check that ultrasound report. If it's correct, make an immediate appointment with an ENT/Otolaryngologist (ear, nose, throat surgeon). With an 8.6 cm nodule, you need surgery to remove it. Even the 2.3 cm nodule is problematic. How's your breathing and swallowing?


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## joplin1975 (Jul 21, 2011)

Agreed. If those dimensions are correct, it needs to be removed ASAP. Are you having any symptoms? Like difficulty swallowing etc?


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## Christys3 (Nov 2, 2016)

Thank you for your replies!! I have updated the ranges. The US report says 8.6 cm. I keep hoping it is a typo and it really should say mm, but all of the nodules described are presented in cm and only the isthmus is measured in mm. The only nodule that is described in the "impressions" section at the bottom of the report is the 2.3 cm nodule. There is no mention of the 8.6 cm one. I have had some funny feelings while swallowing for a few months now but thought that it was a swollen tonsil. Do I need a referral to see most ENTs or can I just call one? So new to all this and feel frozen on where to start. Thank you again so much for passing on your knowledge!


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## Octavia (Aug 1, 2011)

Honestly, I can't help but think there's a typo there, especially since there's no mention of the 8.6 cm nodule in the "impressions" section of your ultrasound report. Perhaps call the clinic that did the ultrasound just to make sure. 8.6 cm is huge...like alarmingly huge. My nodule was "only" 3.2 cm and it was causing voice issues and quite a bit of discomfort. I can't imagine what an 8 cm nodule would do!

As far as whether you need a referral for the ENT, that will depend on your insurance. Call the 1-800 number on your card and see what they say. But since you have at least a 2.3 cm nodule, you'll want to have a needle biopsy done, and most likely that will be done by an ENT. If you need a referral, you should have zero problems getting one.


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## Christys3 (Nov 2, 2016)

Thank you for your reply, Octavia! It has given me my next steps, which I did not have before! Can't thank you enough for taking the time!


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## creepingdeath (Apr 6, 2014)

8.6 cm is large !!!!!!

My thyroid "both lobes" were swelled to about that size "with no nodules" before hormone treatment.

You could see the goiter from across a room and I could feel that extremely annoying pressure from the swelling in my neck .

The Doctors were surprised I had no breathing or swallowing issues.

Can you see the swelling in your neck?

Or feel a lot of pressure?

If not, I'm sure it's just a type O.....


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## Christys3 (Nov 2, 2016)

Thank you for your reply, creepingdeath!
I very much appreciate your insight. I just keep going over the US report. Does it make sense that the right lobe would measure 5 cm and have a nodule 8.6 cm "within the inferior right lobe". Can it grow in such a way that this is possible? I do have minimal swelling in my neck and a feeling that I am wearing a too tight turtleneck, but nothing that looks like a three inch mass is present. I got an earlier appointment this Wednesday. So, praying for some answers soon.


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## creepingdeath (Apr 6, 2014)

I have learned that anything is possible with thyroid disease.

Sometimes the thyroid or tumor grows inward and is less obvious to see as a lump.

Thyroid disease is very strange and effects everyone differently.

Some people have no symptoms or signs at all and others like me have such extremely horrible symptoms that they start to prepare for their own death.

At your appointment show the doctor your ultrasound results and tell him or her you have concerns that there may be an error and ask for another Ultrasound .


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## visc (Feb 22, 2014)

That nodule though... Get it checked for sure.

With regards to your antibody level.. You could have just gotten sick with a virus or something.. It's normal to detect a few when you are not sick and a little more when you are. I guess you'll know if they keep rising for you.

My endo from Strong Hospital says we don't know what higher than normal antibodies really means yet besides you have hashimotos or graves. Antibodies are just signals to the immune system. The real damage comes from how active the immune system is against the thyroid. In short, we aren't sure if antibodies reflect the aggressiveness of the disease according to her.


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