# Labs and Ultrasound results



## carinabear (Apr 28, 2010)

Hi, I am new to this board; finding it as a result of my newest issue.

I am being treated by an Ortho for neck, shoulder and knee problems from a fall at work. In order to clear me to knee surgery he did a MRI on my neck as I am having bad neck pain. The MRI had some disk buldging, etc but he cleared me for surgery. When I read the MRI results I saw the following.

Incidental note of a right thyroid lesion measuring at least 2.5 cm and possible larger. The lesion is partially visible on the axial scan only. It has thin walls with well defined margins. Ultrasound is recommended as the next best step in further evaluation. Ortho never mentioned it to me but when I read it I took it to my primary.

She ordered blood work and an ultrasound immediately. The labs and ultrasound came back yesterday and she referred me to an endo to be seen immediately. She also will not allow my knee surgery and general anesthesia at this time because she said I could have cancer and this needs to be evaluated first. The Ortho has put the knee surgery on hold.

My dad had Hashi for 25 years plus. He did not have cancer, however by the time they diagnosed Hashi he already had damage as a result. He died from heart disease believed to be complications from Hashi. So I do have family history.

My labs show the following:

TSH, 3rd generation In Range 3.47 mIU/L (normal range .40-4.50)
T3 uptake 29 (normal range 22-35)
T4 9.6 (normal range 4.5-12.5)
Thyroglobulin Antibodies 31 (normal range <20)
Thyroid Peroxidase Antibodies 34 (normal range <35)

Ultrasound:

The thyroid gland is diffusely enlarged and heterogeneous. The right lobe measures approximately 5.5cm in length and the left lobe approximately 4.7cm in length. This is an oval nearly isoechoic nodule occupying the mid and inferior right lobe of the thyroid gland measuring approximately 3.5x2.5x2.0 cm.

I go to an endo on Monday as an emergency appt as my dr told them she feared cancer. I am completely freaking out about cancer. Is this really a good possibility? I understand my tests could indicate hypo or hashi but cancer?

If anyone can give me some insight on my labs I would really appreciate it.


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## GD Women (Mar 5, 2007)

Yes, you have family history of Hashi but this doesn't mean you will have Hashi. It does mean you are more susceptible to any of the autoimmune disorders, including Graves' disease. However, your test does not indicate Hashi and your antibodies are not all that out. Your levels might indicate inappropriate TSH Syndrome of tumorous or nontumorous origin.

Usually Ultrasound can only detect thyroid nodules-benign or malignant-of sizes of less than 1 cm.

A fine needle aspiration FNA is proven to be best. FNAs have a diagnostic accuracy of over 98%, though it is highly dependent on the physician's expertise in performing the test.

CT scan of the neck to evaluate lymph nodes and an MRI of the neck to evaluate muscle or tracheal involvement. Some also recommend a bone scan and chest x-ray, as thyroid cancer can (rarely) metastasize to the bones and lungs.

I know you are nervous and perhaps up set too, I know I would be.
Please keep in mind that more than 90 percent of all thyroid nodules are not cancerous. If it is, it is very successfully cured and treated.

Keep us up-dated.

You will be in my thoughts and prayers.


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## carinabear (Apr 28, 2010)

Thank you. I doubt it is Graves as I have a lot of hypo symptoms. Hair loss, recent weight gain, fatigue, cold intolerence, muscle aches, joint pain, etc. I really didnt pay much attention to the symptoms until all this happened. I have also ignored a lot of over the past 6 months as I was dealing with knee, neck and shoulder issues from my fall at work. So I attributed a lot of it to the fall and not to Thyroid. I am just nervous it is cancer. The dr's reaction of needing to get in right away, having my knee surgery cancelled and saying it might be cancer is what really upset me.

I have an appt on Monday with an endo and I spoke to the Mayo clinic in Jacksonville which is close to me and was accepted there as well. Although they would be out of network and expensive for me. So I set an appointment up there since they were booking 2 months out for a second opinion if the endo says it is cancer.

I am really worried, I know you say not to be but it is hard when thinking about the possibility of cancer.


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## GD Women (Mar 5, 2007)

I didn't mean to suggest it was Graves' nor Hashi because your levels do not relate to Hashi or Graves' levels. What I meant was that your dad being Hashi which is autoimmune, and beings autoimmune run in families, you have a chance to be autoimmune. It doesn't matter which autoimmune disease, it can come in any one of the hundreds of autoimmune diseases, that is up to your system. So it doesn't necessarily mean it will be Hashi (or Graves'). Although you have more of a chance for thyroid autoimmune, thanks to your dad:winking0051: LOL! A lot of other health and autoimmune diseases share the same symptoms or a lot of the same symptoms, including thyroid symptoms. Hypos and hyper can share some of the same symptoms too. Sometimes I think whoever wrote them up got hyper and hypo symptoms mixed up. LOL!

Good luck Monday - let us know. Mean while, try to relax until then. Stress is not good for any illnesses.


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## Andros (Aug 26, 2009)

carinabear said:


> Hi, I am new to this board; finding it as a result of my newest issue.
> 
> I am being treated by an Ortho for neck, shoulder and knee problems from a fall at work. In order to clear me to knee surgery he did a MRI on my neck as I am having bad neck pain. The MRI had some disk buldging, etc but he cleared me for surgery. When I read the MRI results I saw the following.
> 
> ...


Carinabear............welcome. The rate for cancer of an isoechoic nodule is about 13%. That is very low. However, your doc sure is a good one. I am very very impressed!

The one thing about thyroid cancer is 99.9% of the time; it is entirely treatable and entirely eradicated. Let's hold on to that hope and a little piece of information.

We are here for you and we all can share in your emotions and feelings right now. It "is" scary; there is no denying the fact of it.

Let us know what happens Monday and I sure hope it is good news! The whole story is wild. I am sorry you fell and got hurt so badly but maybe, just maybe..................??? Know what I mean? Otherwise you would never have known.

Sending gentle hugs (you need them)


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## Mariposa (Apr 10, 2010)

Just wanted to pop in and say hello. And that I am really glad you got into see a Dr so soon. Let us know how it goes.


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## Andros (Aug 26, 2009)

carinabear said:


> Hi, I am new to this board; finding it as a result of my newest issue.
> 
> I am being treated by an Ortho for neck, shoulder and knee problems from a fall at work. In order to clear me to knee surgery he did a MRI on my neck as I am having bad neck pain. The MRI had some disk buldging, etc but he cleared me for surgery. When I read the MRI results I saw the following.
> 
> ...


We will be waiting to hear from you tomorrow (Monday 5/3.) Good luck!


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## chopper (Mar 4, 2007)

Yes, certainly don't put the cart before the horse. You'll probably get a painless biopsy to see what kind of cells are in there and then maybe a radioactive iodine uptake test to see how well your thyroid is functioning. I do not think this is a "drop everything and check into the ER" kind of a situation. If it happens to be cancer, most thyroid cancers remain very well contained and are easily taken care of, relatively speaking. You'll be ok.


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## carinabear (Apr 28, 2010)

Thanks to all of you.

Met the DR today. He felt the nodule/goiter and he feels it is significant. He also mentioned that my antibodies could indicate cancer but that only 1 in 20 nodules are cancerous. He scheduled me for a biopsy in 3 weeks. He put my on synthroid today as he feels with the family history, symptoms and boardline labs along with the nodule it is the best course of action. He will not clear me for knee surgery as he said the anesthesia could/possible change the biopsy results and dosent want to risk it. He said I will know sometime beginning - mid June the results of the biopsy, so I'll be nail biting until then.

He also suggested that I schedule a second opinion for the Mayo clinic (nearby) in case it is cancer. He said that they are booking 6-8 weeks out and it gives us time to find out. He said I can always cancel the appointment but if I wait 4 weeks plus to get the results and then book it then I have to wait that much longer. I called Mayo today. They called me back several hours later after reviewing my case and since my dad was a patient for thyroid as well as heart they agreed to look at me and booked me an appointment for June 14.

This is SO overwhelming. I just wanted knee surgery and now I am dealing with all these doctors, Mayo clinic and possible cancer. I guess I should be happy I have insurance and am able to be seen by doctors right away. I am still nervous.

Thanks again for the support


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## Andros (Aug 26, 2009)

carinabear said:


> Thanks to all of you.
> 
> Met the DR today. He felt the nodule/goiter and he feels it is significant. He also mentioned that my antibodies could indicate cancer but that only 1 in 20 nodules are cancerous. He scheduled me for a biopsy in 3 weeks. He put my on synthroid today as he feels with the family history, symptoms and boardline labs along with the nodule it is the best course of action. He will not clear me for knee surgery as he said the anesthesia could/possible change the biopsy results and dosent want to risk it. He said I will know sometime beginning - mid June the results of the biopsy, so I'll be nail biting until then.
> 
> ...


You have a wonderful and caring doctor!! What a blessing!!! Thank you so much for letting us know and you will be in my prayers throughout.

Please let us know when the biopsy will be and stick around because we do have some awesome support here.

I know you are nervous but I personally would rather know than to not know. This way, the docs can get right on it.


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## hillaryedrn (Dec 14, 2009)

Hi there! I'm glad you got in to see an Endo! Even if it is cancer, things will be fine! I know it's hard, but try not to worry too much until you know something for certain. A biopsy is the perfect next step to take. It is painless and over in a matter of minutes. Keep us updated!!


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## mememe (Mar 18, 2010)

Just curious, how did your trip to the Mayo clinic go?


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