# Thyroid Ultrasound concern with Lymph Nodes and Nodules



## Kaykay2 (Apr 13, 2015)

Hello everyone, I recently had an ultrasound and have some concern.

I don't have the report beside me for the correct verbiage, however these are the things I recall:

I have 2 nodules on my left Thyroid Gland, both measuring above 12mm....I believe one to be 12.9mm and the other 12.4mm. Both with internal blood flow.

The other concern is the lymph nodes both being enlarged (I'd have to get the exact measurements.)

The U/S recommended F/U in one year for Stability. All the Doc said at result time was we will F/U in 6 mths.
My inquiry to him was, may I have a Refferal to a Specialist, as well as, getting him to do a Thyroid Panel.
Has anyone experienced these kind of results?


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## Andros (Aug 26, 2009)

It would be a good idea to see an ENT at this point! Good to hear from you.

If you can, get a copy of the ultra-sound so we can read exactly what it says.

Hugs,


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## joplin1975 (Jul 21, 2011)

12mm = above the 1cm mark which = a need for a biopsy. Especially with enlarged lymph nodes.


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## Kaykay2 (Apr 13, 2015)

Findings:Ultrasound of the Thyroid gland was obtained.

The right lobe of the thyroid gland measures 5.0 x 1.6 x 1.1 cm and appears slightly heterogeneous. No discrete nodule is identified. There is normal blood flow. Sub centimeter short axis lymph node is visualized within the right lateral soft tissues measuring 12.4 x 5 x 2.4 mm.

The isthmus measures 0.3 cm and appears within normal limits.

The left lobe of the thyroid gland measures 3.6 x 1.5 x 1.2 cm.
Within the medial left lobe, near the isthmus there is a hypoechoic nodule measuring 5.4 x 4.4 x 3 mm which demonstrates mild internal blood flow. There is a mid left thyroid nodule also visualized measuring 4.1 x 2.7 x 1.6 mm which demonstrates internal blood flow.
Sub centimeter short axis lymph nodes are visualized on the left measuring 13.9 x 5 x 2.0 mm and 12.3 x 4.8 x 2.4 mm.

Impression: Sub centimeter left thyroid nodules, as detailed above.
Recommend follow-up ultrasound in 12 months to evaluate for stability.


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## Kaykay2 (Apr 13, 2015)

Thank you Andros I just grabbed the report and posted it. I was wondering which I should try to make an appt for an ENT or Endo. What benefits would be for each? 
I posted in the newbie section too, that it's been awhile. I'm glad to see u guys again too. 

Thanks Joplin, I remember u as well.  are u actually in Joplin? A couple hours from me? lol.
A biopsy is my goal. It's just I have to try not to procrastinate.


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## joplin1975 (Jul 21, 2011)

Hi again  No, I'm a Janis Joplin fan. I actually live in New York!

Unless you have an endocrine surgeon, most endos, it seems, refer out for FNAs. Which is probably why Andros was suggesting an ENT, who might be able to get the FNA done more quickly.


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## Kaykay2 (Apr 13, 2015)

Good advice. Thank you.

And yeah....I believe ur more than a couple hours away from me then.


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## Andros (Aug 26, 2009)

She could really belt it out. I liked her too!


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## Andros (Aug 26, 2009)

Internal blood flow concerns me. Sometimes it comes from an independent source which does suggest biopsy (FNA.)

Thank you so much for furnishing all that. Truly!

Hugs,


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## Kaykay2 (Apr 13, 2015)

That's my concern, Andros. Thank you for being honest with your opinion. 
It was my pleasure to produce the results for you.

I actually have more on a Thyroid Panel that I received today:

T3 Uptake: 31 (22-35)
T4 (Thyroxine), Total: 7.6 (4.5-12.0) mcg.
Free T4 Index (T7): 2.4 (1.4-3.8)

Reckon this would specify anything in relevance to the US report?


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## Kaykay2 (Apr 13, 2015)

I seen an ENT today.


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## jenny v (May 6, 2012)

That's a good step. ENTs are usually much more proactive in doing ultrasounds and biopsies (if there is anything that needs biopsying).


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## Kaykay2 (Apr 13, 2015)

Thank you for the kind words, Jenny. I apologize, I meant to post what became of the visit but became busy and left it at a partial posting.

The ENT Specialist stated if he'd seen my "recent" Ultrasound reports ONLY, there would be no concern. However, I just so happen to have found a Thyroid Ultrasound I found from 3 years prior. I brought them for comparison.

April 18, 2013:

Examination: Thyroid Ultrasound
Indication: Thyromegaly

Findings:
The right lobe measures 1.4 x 4.0x 1.6 cm. Left lobe measures 1.3 x 4.3 x 1.4 cm. Echotecture is homogeneous. There is no extrathyroidal abnormality.

Impression: Normal Thyroid Ultrasound.
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4/8/15 (I'm just posting the measurements, the rest of the verbage is posted in this thread.)

US THYROID:

Right lobe of the thyroid gland measures 5.0 x 1.6 x 1.1 cm and appears slightly heterogenous.

The Left lobe measures 3.6 x 1.5 x 1.2 cm

Then of course the verbage of the 2 nodules and short axis lymph nodes.

Isn't that quite a bit of a change within a 3 year span?

He basically sat down and told me we could remove the thyroid or wait and repeat the US in 5 months. He stated they were really too small to biopsy. 
Then he utilized a long camera probe in my nose, that went down the back of my throat (to find the cause of the choking sensation I have) and said I was pretty swollen (my throat) and no wonder I was diagnosed with Sleep Apnea. I asked him, "on a scale from 1-10 how bad is it swollen?" He said, " About an 8" and it was due to LPR (Laryngopharyngeal reflux) often called "Silent Reflux," because it's not always associated with Heartburn or Pain.
He then placed me on 40 mg of Nexium 2x daily....which is a HEAVY dosage that needs to be taken for at least 4-6 months for healing.

So I guess we just wait to re-check the Thyroid US in 5 mths and then utilize the camera scope around the same time to re evaluate the healing process from the LPR.

(However, my Husband is now mentioning we need to seek out an Endo now. Which I've stated this whole time....in addition to the ENT.)


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## Kaykay2 (Apr 13, 2015)

Has anyone had any Genetic Testing performed? I'm unsure if it has anything OR alot to do with the Hormones or Thyroid. The results have to do with certain Genes, Metabolizer's, Risk Factors....then goes on to give Therapeutic Recommendations.

One sticks out, or rather a few do. I know I've had lab results before where my INR was below the threshold....it was low. It's stating Therapeutic Recommendations to start Wafarin.
CARDIOLOGY: Consider 5-7 mg/day to achieve therapeutic INR using the warfarin product insert approved by the USFDA. 
Similiar Verbage for Beta Blockers and Clopidogrel (whatever that is.)

I guess my blood isn't clotting correctly? Or too much? 
Anyway....I'm unsure if any of these results could cause anything to go hypo or hyper.


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