# Ultra sound findings



## Kate1177 (Aug 24, 2014)

I got diagnosed with Hashimotos last year. I went into the doctor because i was having pain in the front of my neck and I couldn't figure it out along with other things like sensitive to the cold, hair loss, my food getting stuck in my throat. She felt my thyroid and it was enlarged so from there I had blood tests done ultrasounds a biopsy done on some nodules. My question is the endocrinologist that I go doesn't seem to take a interest in my chart and has over looked some important things. Im looking at getting a different opinion but wanted to post my finding here.

Fist one 8/14/14

XAM: THYROID ULTRASOUND

INDICATIONS: 36 years old Female patient presents with
abnormal thyroid lab tests

COMPARISON: None.

FINDINGS:

Right lobe:

The right lobe overall measures 5.9 x 1.6 x 2.1 cm. 10.4 cc
Nodule #1: Mid to inferior pole hypoechoic nodule,
measuring 1.5 x 0.9 x 1.3 cm.
Left lobe:
Nodule #1: Lower pole heterogeneous peripherally
hypoechoic/centrally hyperechoic nodule measuring 1.5 x 0.9
x 1.2 cm

The left lobe overall measures 5.5 x 1.8 x 2.2 cm. 1.4 cc

Isthmus:
No evidence for nodule or cyst; overall thickness = 2.8 mm.

IMPRESSION:
Bilateral single thyroid lobe nodules, which are solid and
somewhat heterogeneous. There is minimal internal
vascularity seen within both nodules.

Consider referral to endocrinology for fine-needle sampling
of thyroid nodules greater than 1 cm in 2 dimensions.

The second one 12/17/14 ( this one a new one nodule was found but my endocrinologist didn't see it)

EXAM: US HEAD/NECK/THYROID

INDICATIONS: 37 years-old Female. "f/u thyroid nodules,
please compare to 8/2014 ultrasound"

COMPARISON: August 12, 2014

FINDINGS:
Right lobe: Measures 5.9 x 1.4 x 1.7 cm (7.3 cc). Diffusely
heterogeneous echotexture. There is better visualization
today of a heterogeneously hypoechoic region in anterior
midpole which does not appear to be a true nodule. 1
questionable nodule:
1. Posterior medial midpole vague hypoechoic nodule or
pseudo-nodule 0.9 x 0.9 x 0.5 cm, previously 1.5 x 1.3 x
0.9 cm

Left lobe: Measures 5.5 x 1.5 x 2.2 cm (9.5 cc). Diffusely
heterogeneous echotexture. 1 possible nodule:
1. Posterior lower pole isoechoic lobule outlined by
hypoechoic parenchymal bands measures 1.5 x 1.2 x 0.9 cm,
stable

The thyroid gland overall is diffusely mildly hypervascular.

Isthmus: 3 mm.
1. Left para-isthmic hypoechoic solid hypervascular 1.5 x
1.2 x 0.9 cm, stable

Please note that nodules smaller than 6 mm in diameter may
be present but not reported.

*Impression*

IMPRESSION:
1. Diffusely heterogeneous mildly hypervascular thyroid
gland suggesting Hashimoto's. Multiple areas of
questionable nodules versus relatively focal glandular
heterogeneity are stable or smaller.

This is the last one 8/7/15

EXAM: US THYROID

INDICATIONS: 37 years old Female patient presents with
Follow up thyroid nodule

COMPARISON: December 2014

FINDINGS:

The right lobe measures 58 x 16 x 23 mm. Nodule in the
upper pole has decreased in size now measuring 11 x 7 x 5
mm. There is a heterogeneous hypoechoic nodule in the lower
pole posteriorly measuring 11 x 7 x 5 mm. The left lobe
measures 56 x 19 x 21 mm. Diffuse heterogeneity present.
Stable nodule in the lower pole measuring 15 x 10 x 9 mm.
Stable nodule in the left-side of the isthmus measuring 11
x 6 x 10 mm; there is also a small cyst in the isthmus
measuring 6 x 4 x 2 mm.

*Impression*

IMPRESSION:

Relatively stable findings in the right lobe, isthmus and
left lobe as described above.

*Component Results*


----------



## Lovlkn (Dec 20, 2009)

What do your thyroid labs look like? Do you have any you can post with ranges?



> my food getting stuck in my throat.


Enlarged thyroid, choking, nodules - If you went to a surgeon they likely would remove. \


----------



## Kate1177 (Aug 24, 2014)

Component Results
Component	Standard Range	Your Value	Flag
Thyroid Stimulating Hormone	0.46 - 4.68 uIU/mL	1.15	
Component Results
Component	Standard Range	Your Value	Flag
Thyroid Peroxidase Ab	0 - 60 U/mL	214	H
Antithyroglobulin Ab	0.0 - 60.0 U/mL	261.0	H


----------



## Kate1177 (Aug 24, 2014)

Component Results
Component	Standard Range	Your Value	Flag
Triiodothyronine (T3), Free	2.30 - 4.20 pg/mL	2.80


----------



## Kate1177 (Aug 24, 2014)

Component Results
Component	Standard Range	Your Value	Flag
Free Thyroxine (FT4)	0.78 - 2.19 ng/dL	1.03


----------



## Andros (Aug 26, 2009)

Welcome to the board!

It is my strong recommendation that you see an ENT. Any time solid and vascularity presents it's self, cancer must be considered. Combine that with high antibodies, you would be errant to not press for this.

Above is a humble opinion only but one that should be taken seriously.

Sending hugs; I know you don't feel well!


----------



## Kate1177 (Aug 24, 2014)

Thank you andros,

I have been going to see an Endo but I feel like he has missed too many things like on my second ultrasound a third noduel popped up and he didn't notice I had to tell him. Then he scheduled me to get a ultrasound done but scheduled it for the following year when it was supposed to be for this past summer . And according to the second ultrasound it looks like that one should be biopsied but he said without even noticing then I got a third nodule that it looks fine! I'm looking to get a new endo and I'm wondering from my ultrasound that third that's in the middle should it get biopsied? It showed up in less than four months?


----------



## Kate1177 (Aug 24, 2014)

I should mention two of the nodules have been biopsy and they came back normal.


----------



## mstar1125 (May 6, 2014)

I'm in no way an expert, but I would consider a nodule that popped up in 4 months may have always been there and was just missed at the initial ultrasound. The changes in size are also confusing to me, but that may be measurement error due to different technicians, different angles of measurement, etc. It couldn't hurt to get a second opinion regarding whether the third nodule should be biopsied.


----------



## Kate1177 (Aug 24, 2014)

Hi Mstar1125,

I was thinking the same thing my only hold back on the fact that it was missed on the first ultra sound was that it is on the Isthmus. Im no expert and i have been wondering this same thing. When I told my endo that I only had 2 nodules and that the 3 one is a new one he said that its a little worrisome. But he didn't order a biopsy for that one and he said that the pain in the front of my neck couldn't be related to my thyroid at all. I have never gone myself and gotten a second opinion on something i don't really know how to do something like that. I just wanted to run my test results by other people that deal with the same thing and get a few opinions.


----------

