Can I insist on a fine needle aspiration if a single nodule is detected?

I've just come back from seeing my GP about a lump on my neck in the thyroid area. I have had a sore throat for at least 3 months and have been prescribed antibiotics 3 times already for bacterial infections. I frequently lose my voice, one for almost 4 weeks constantly, or otherwise my voice is very deep and hoarse particularly in the mornings. I've had the sensation of a lump in my throat around Adam's apple height, and have a palpable nodule slightly off centre near the base of my throat. Today my GP finally decided to refer me on an urgent basis because of the growth of the lump (which begs the question why he hasn't done a standard referral sooner), to an ENT surgeon. He said that they would 'hopefully' scan my thyroid but if they didn't he would have to arrange that himself afterwards.

Is it normally an ENT specialist who would carry out the scan, or an endocrinologist? Also if a lump shows up am I within my rights to request a FNA or is that not necessary at this stage?

I think my concern comes from the fact that my hypothyroidism seemed to come on very quickly, and at first the bloods pointed more towards secondary hypothyroidism as TSH was in the lower range of normal but FT4 was well under range. My TSH has gone up quite steadily in the space of a few months which took my GP by surprise and contradicted what my endo said would be a normal pattern. I suppose I'm worried that the lump could point towards something more serious, and want to be sure it gets thoroughly checked out, but don't want to look like an idiot if a FNA isn't needed in these circumstances.

Sorry for the essay, and thanks in advance.

8 Replies

  • ENT and Endo request scans & FNA, and any other tests if required. Scan will show the size, appearance and location of the nodule. I think most enlarged single nodules will be FNA. If not ordered you are entitled to ask why and would be an idiot if you didn't raise it. I had ultrasound guided FNA ordered by Maxillo Facial surgeon. I was under the care of the surgeon and oncologist for 6 months before being passed to the endocrinologists.

  • Thanks clutter. That's really helpful

  • Good :)

  • Hi A specialised radiologist does the ultra sound of the thyroid, GP or better endo referral. If nodule essential to have it biopsied by radiologist etc.Swallowing etc is a specialised ENT, not generally , they do a scope in out patients, simple as only the top end, this does not show thyroid.

    Do make sure and see both. probably fine, I have very bad problems like that but checks not cancer.


  • Thanks Jackie x

  • I have a multi nodular goiter and will relate my experience. I went to GP who ordered a full blood test and ultra sound. The radiologist told me that I had the nodules and the way ahead. I was then referred to an ENT who examined the nodules by camera. He stated they were not cancerous and as I had no difficulties swallowing, my GP should have sent me to an Endo. He referred me on.

    I was told by Endo that an FNA to test the largest nodule was not necessary as they had been examined by the ENT consultant by camera.

    From my reading, a single nodule always involves FNA to determine if it is cancerous. there is a lot of information on the web about the procedure. Try not and worry as the outcome of having a nodule even if cancerous is excellent. One sure thing is that you will be closely monitored from now on. I should also do some reading so that you can ask the necessary questions.

    Take care and do not worry.....

  • Hi, thanks for this, it's a great comfort x

  • Hi Nodules are biopsied with a fine needle under an ultra sound. However, NHS often due to cost, say we will keep an eye on it, not good, fight that.


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