# thyroid nodule - 1.2 * 1.3 cm. and 1.8*1.2 cm



## Anupam.cs (Feb 16, 2016)

Team

Please help me understand following report, I wanted to know how severe my condition is ? I wanted to know how serious i should take following report -

ULTRASOUND OF THE NECK WITH COLOR DOPPLER

CLINICAL INDICATION : Hyperthyrodism

Ultrasound of the neck was performed with attention to the thyroid gland, Color flow study was performed.

The right thyroid measures 4.8 * 1.7 * 2.0 cm. for a volume of 8.9 cc., mildly enlarged and heterogeneous. there is a 1.2 * 1.3 cm. hypoechoic nodule that has an indistinct border. there is no intra nodular increased blood flow.

the left thyroid measuers 5.0*1.9*1.6 cm. for a volume of 8.2 cc., mildly enharged and there is a vague indistinct nodule measuring 1.8*1.2 cm in the mid pole.

Doppler study shows no increaded blood flow.

The bilateral neck reveals small normal sized nodes. there is no lymphadenopathy.

IMPRESSION :

The thyroid glands bilaterally are modetately enlarged and there are indistinct nodules seen. the right nodule measures 1.3 cm and the left nodule measures 1.8 cm. in size. There is no hypervascularity or calcifications. No cervical lymphadenopathy seen. No prior study for comparion.


----------



## joplin1975 (Jul 21, 2011)

When you look at nodules, red flags are: larger than 1cm, hypoechoic, hypervascular, and calcified.

Since you have two of those characteristics, you should get the nodule biopsied. That said, the vast majority of nodules are benign.


----------



## Anupam.cs (Feb 16, 2016)

joplin1975 said:


> When you look at nodules, red flags are: larger than 1cm, hypoechoic, hypervascular, and calcified.
> 
> Since you have two of those characteristics, you should get the nodule biopsied. That said, the vast majority of nodules are benign.


 joplin1975 -Thanks for the quick reply.

Is the nodule biopsied process involve surgery ? whom should i consult Endocrinologist or ENT doctor ?


----------



## joplin1975 (Jul 21, 2011)

No, it is not a surgical procedure. They use a very small needle -- it's called an FNA or fine needle aspiration -- and simply insert that through the skin and into the thyroid nodule. Sometimes they use an ultrasound to "guide" their process. It will depend upon how prominent the nodule is and how close it is to the front of your neck.

There isn't one "right" doctor to do the FNA, although you will find doctors with more of a surgical inclination tend to do more FNAs. So, it's likely an ENT will be more interested in an FNA. I had a general surgeon (with a specialty in thyroids) do mine. I could have also chosen to have a radiologist do it.


----------



## Anupam.cs (Feb 16, 2016)

joplin1975 said:


> No, it is not a surgical procedure. They use a very small needle -- it's called an FNA or fine needle aspiration -- and simply insert that through the skin and into the thyroid nodule. Sometimes they use an ultrasound to "guide" their process. It will depend upon how prominent the nodule is and how close it is to the front of your neck.
> 
> There isn't one "right" doctor to do the FNA, although you will find doctors with more of a surgical inclination tend to do more FNAs. So, it's likely an ENT will be more interested in an FNA. I had a general surgeon (with a specialty in thyroids) do mine. I could have also chosen to have a radiologist do it.


Sir, Thanks for your time and reply. I will keep you posted about my reports.


----------



## Anupam.cs (Feb 16, 2016)

joplin1975 said:


> No, it is not a surgical procedure. They use a very small needle -- it's called an FNA or fine needle aspiration -- and simply insert that through the skin and into the thyroid nodule. Sometimes they use an ultrasound to "guide" their process. It will depend upon how prominent the nodule is and how close it is to the front of your neck.
> 
> There isn't one "right" doctor to do the FNA, although you will find doctors with more of a surgical inclination tend to do more FNAs. So, it's likely an ENT will be more interested in an FNA. I had a general surgeon (with a specialty in thyroids) do mine. I could have also chosen to have a radiologist do it.


Doctor,

One more question -

If these nodule are detected as benign.

Do we still need to perform ultrasound and biopsies every year for these nodule ?


----------



## joplin1975 (Jul 21, 2011)

It depends.

If they remain stable and you don't have worsening symptoms, you could skip the biopsies (although regular ultrasounds are a good idea).

If things change, repeat FNAs are pretty common.


----------



## Anupam.cs (Feb 16, 2016)

joplin1975 said:


> It depends.
> 
> If they remain stable and you don't have worsening symptoms, you could skip the biopsies (although regular ultrasounds are a good idea).
> 
> If things change, repeat FNAs are pretty common.


Thanks for your help.


----------



## WhatHappened (Nov 12, 2015)

For example, my endo is doing my biopsy/fna in a week or so. But has already told me because of my history he will recommend regular surveillance of my thyroid if it comes back negative (the only 100 way to be sure is remove the thyroid and look at it)


----------



## Anupam.cs (Feb 16, 2016)

For my condition i visited one of the famous doctor in Pune,INDIA

He did thyroid scan, blood test and thyroid ultrasound. All the results are good and normal.

There is no nodule detected, Is it possible ?

In December 2015 ultrasound there was 2 nodule now there is no nodule, I am not sure if this is possible. Please advice.


----------



## joplin1975 (Jul 21, 2011)

It would be unusual if the nodules originally seen were solid. Your report never mentioned that. If the nodules, however, were cystic, it can and does happen.


----------



## Lovlkn (Dec 20, 2009)

> All the results are good and normal.


Do you have the actual reports in your possession?

Many times a doctor will tell a patient all if "normal" even if there are some items other than "normal" revealed during the test. The only way to confirm your results is to obtain a copy of the reports.


----------



## Anupam.cs (Feb 16, 2016)

Lovlkn said:


> Do you have the actual reports in your possession?
> 
> Many times a doctor will tell a patient all if "normal" even if there are some items other than "normal" revealed during the test. The only way to confirm your results is to obtain a copy of the reports.


Yes, I have actual report as well as ultrasound copy. The december 2015 ultrasound was performed in NJ, USA.

This time in INDIA, The radiologist took the help from another radiologist as he was not able to see the nodules and he reconfirm with his colleague that thyroid is normal and no nodules detected.

Also he was surprised because he never seen this type of case where the nodules disappear after sometime.

So my question is -

1. The nodules may disappear after few months ? is it a normal case ? In my case there was 2 nodules.

2. If nodules cannot disappear ? do i need to consult NJ USA doctor again to revalidate the report?

Please help.


----------



## Anupam.cs (Feb 16, 2016)

joplin1975 said:


> It would be unusual if the nodules originally seen were solid. Your report never mentioned that. If the nodules, however, were cystic, it can and does happen.


Thanks for your help again.


----------

