Deciphering Ultrasound Results

[astrelle_s]

Hello all...I'm new here and was hoping someone could help explain the results of my thyroid scan.

I'm 44, have had an enlarged thyroid since my early 20's but always had normal blood work, and one previous normal ultrasound scan.

At my checkup this year, my doctor decided I should have an updated scan of my thyroid (although my blood work is still normal). I received a callback today that I have a single nodule.

The report read:

"In the upper pole right lobe there is a well-circumscribed hypoechoic complex cystic appearing nodule measuring 1.1 cm x 1.1 cm.

Given the appearance of this nodule, and age of the patient, image guided biopsy may be considered."

From what I have gathered, I'm thinking this means the nodule has well defined borders and is partially cystic and partly solid? How concerning are these results?

My current TSH is 1.829.

I've been referred to an endocrinologist and will have the biopsy. I'm just trying to make sense of everything at this point.

Any thoughts would be appreciated.

[Haze1975]

The biopsy isn’t that bad. They scan your neck again. And find the 1.1 cm x 1.1cm and put a fine point needle in it and take a sample. They will test it and results will be back. It can be one of two things. Until they run the test on the sample they don’t know what it can be. (This is what happened to me in the uk) it is easy. Results depending on what it is different. Good luck.

[Greekchick]

Hello Astrelle,

Haze 1975 has exactly described what will happen with the biopsy. I had the same thing happen to me at your age, with normal blood work, but I had a multinodilar goiter and needed biopsies of each nodule. You will likely need biopsies on a regular basis (every year or other year) to monitor your nodule - and do remember that 98% of all thyroid nodules are benign. Be prepared for a bit of discomfort depending on where the nodule is located and how easy it is to reach with the needle, and you may have a bit of bruising, so don’t worry. You also should not drive afterwards and plan not to do anything strenuous for the rest of the day. I hope this information helps and all the best with the upcoming test. Sending you good thoughts!

[SilverAvocado]

For things like this I think it's very important not to get stressed and build it up into something really damaging in your life.

I had thyroid cancer several years ago. Years before I'd had a friend who had a benign nodule, and she was emotionally destroyed by it, wracked by worry and became a shadow of herself. It was only once I went through the whole process myself that I realised what had happened to her wasn't dangerous or serious at all. It was just her own thoughts about it that had hurt her so much.

When I went into my own cancer treatment I was really determined not to let that happen to me. In the end I've been very unlucky with my health, and have been quite disabled from the treatment, but it's still helped me a lot to go in aware I don't want to end up like my friend. And I think even through all the illness I never really have suffered in the way she did. It's really made me aware of how our minds so these things to us!

[SilverAvocado in reply to SilverAvocado]

Ooh, looking at that TSH it is pretty ideal, not just 'normal', which doctors often say even when things are quite bad.

If I were you I'd be tempted to go for a full thyroid panel privately, partly to confirm there is nothing going on that the TSH can't tell us, and partly to have a reference of what your panel looks like today in case it does get worse in the future. TSH is not a great test, it only tells us part of the story.

You can send off for a mail order finger prick test from a place like Bluehorizon or Medichecks, and do the rest yourself at home (details on ThyroidUK website). You need to get TSH, freeT4, freeT3 and thyroid antibodies. Both of those will have packages including all those. If money isn't too much of an issue it is worth getting vitamins as well, ferritin, folate, vitamin B12 and vitamin D, they have packages including all of this. Make sure you get a finger prick microtainer test, some of the larger ones require you to get someone to draw blood.

You can post the results on the forum if you'd like any feedback.

[SlowDragon Administrator]

Would recommend getting vitamins and full thyroid levels tested

[astrelle_s]

Thanks everyone! I'm trying not to stress too much over it until I know there is a reason to. I've had symptoms of a thyroid disorder my whole life, and numerous first and second degree relatives with Hashi's dx, but never been able to pinpoint a specific issue.

From my recent CBC, I am low on calcium, but everything else looked good.

By comparison, I happened to find my CBC from 2007 and TSH was 1.33, MCHC was high, and MVP low. My old doctor never mentioned these specific results to me so I assume he didn't find them concerning, but looking at them now, I see both can be related to thyroid disorders. I'm planning to take a copy to the endocrinologist to review.