Can someone please help me with results

[Siren20]

Results interpretation My Dr’s don’t believe that these are related any other thoughts?!

CT CHEST/ABDOMEN/PELVIS WITH CONTRAST 8/6/2021 3:53 PM

CLINICAL HISTORY: Graves disease. Abdominal pain, generalized. Family

history of Lynch syndrome. Intermittent abdominal pain.

TECHNIQUE: CT scan of the chest, abdomen, and pelvis was performed

following injection of IV contrast. Multiplanar reformats were

obtained. Dose reduction techniques were used.

CONTRAST: 80mLs Isovue 370

COMPARISON: None.

FINDINGS:

LUNGS AND PLEURA: Normal.

MEDIASTINUM/AXILLAE: Heart is normal in size. There is a soft tissue

masslike structure in the anterior superior mediastinum measuring

approximately 4.5 x 2.3 x 3.8 cm in the transverse, AP and

craniocaudal dimensions respectively (image 56 series 3 and image 38

series 7). This could represent thymic remnant, thymoma, teratoma,

lymphoma or other soft tissue lesion of the mediastinum. This does not

appear to be associated with the thyroid. There is a complex nodular

density with enhancement and possible calcifications in the left lobe

of the thyroid measuring up to 1.6 cm in diameter (image 12 series 3).

Thyroid otherwise is unremarkable as visualized. No mediastinal,

hilar, or axillary lymphadenopathy is identified. No central pulmonary

artery filling defects to suggest central pulmonary artery embolism.

This study was not optimized for pulmonary artery evaluation. Thoracic

aorta is of normal caliber and demonstrates no evidence for dissection

or aneurysm.

HEPATOBILIARY: Hypoattenuating lesion in the anterior aspect of the

medial left lobe of the liver (image 134 series 3) measures up to 1.4

cm in maximum dimension with an average density of 12 Hounsfield

units. This likely represents a cyst. Liver otherwise enhances

normally. Gallbladder is normal in appearance. No cholelithiasis,

choledocholithiasis, biliary ductal dilatation or intrahepatic mass is

seen.

PANCREAS: Normal.

SPLEEN: Normal.

ADRENAL GLANDS: Minimal thickening of the medial limb of the left

adrenal gland is grossly within normal limits. Adrenal glands

otherwise enhance normally.

KIDNEYS/BLADDER: Kidneys enhance normally. No hydronephrosis,

nephrolithiasis, hydroureter, ureteral calculus is identified. Urinary

bladder is grossly normal in appearance.

BOWEL: The colon is of normal caliber without pericolonic inflammatory

change to suggest acute diverticulitis. A moderate amount of stool is

seen in the colon. Appendix is normal in appearance. Small bowel is of

grossly normal caliber and appearance. The stomach contains a large

amount of fluid and moderate amount of air but is otherwise

unremarkable.

PELVIC ORGANS: Intrauterine device is seen in expected position in the

upper uterine body/fundal endometrial canal. There is a cystic

structure with thickened enhancing rim in the right ovary. This

measures up to 2.4 cm in diameter and likely represents a collapsing

cyst. Left ovary is normal in appearance. Right ovary is otherwise

unremarkable. Mild thickening of the wall of the vagina is

incidentally noted. Recommend clinical correlation.

ADDITIONAL FINDINGS: No adenopathy or free air is seen in the

peritoneal cavity. There is a small amount of free fluid in the pelvis

which could be physiologic in etiology. Aorta is grossly normal in

appearance and demonstrates no evidence for significant

atherosclerosis, dissection, aneurysm, or narrowing.

MUSCULOSKELETAL: No aggressive osseous lesions or acute osseous

fractures are identified.

IMPRESSION:

1. Masslike structure in the anterior superior mediastinum has

differential diagnosis including thymic remnant, thymoma, lymphoma,

teratoma, or other etiology. Recommend clinical correlation.

2. Probable collapsing cyst in the right ovary.

3. Physiologic amount of free fluid in the pelvis.

4. Heterogeneous nodule left lobe of the thyroid. This could be

better evaluated with ultrasound.

5. No other significant abnormalities are identified.

My nodules in my throat are growing and they are becoming bothersome and all I want to do is sleep all day.

TSH <.01

T3 129

Alk Phos 129

GFR estimate >90

T4 1.53

Thyroid peroxidase Antibody 1,392 IU/ml

TSI 4.1

Please if I could get clarity on probability here that would be great. I’m very analytical and I need to know each out Come that is relatively probable to better handle and prepare for the outcome. Thank you…

[PurpleNails Administrator]

Hello Welcome to the forum

Focusing on the thyroid issues, you have confirmed Graves & nodules?

I can see you TSH is undetectable <0.01. Are your thyroid levels high? Has the FT4 (the free thyroxine) & FT3 (the free triiodothyronine) been tested. Total T4 & TT3 are not as useful. We also need to know the range of your test result which very between labs.

If your levels are high are you treated with anti thyroid medication eg carbimazole or Propylthiouracil?

What have the doctors told you? Any treatment plans or further investigations planned with the thyroid & mediastinum mass?

What is it that the doctors don’t believe are connected?

[Siren20 in reply to PurpleNails]

They don’t believe the mass in my chest and the thyroid nodules are related. I had a biopsy on the left side but they did not biopsy the right there until identified the hurthle cell neoplasm and thyroiditis it is also fast growing and causing symptoms and my cervical lymph node OSS notable swollen as well. I see an ENT today and s as cardio thoracic surgeon (I think that’s correct spelling) as soon as they call me to schedule. I’m on methamazole and my TSH has remained undetectable for nearly a year and the other one has been so fast they couldn’t read it I can’t recall which that is. Yes I did the iodine uptake with nuclear meds and I have Graves it is in my family my grandma uncle mom etc

Blood tests

[PurpleNails Administrator in reply to Siren20]

When you see ENT & cardio thoracic hopefully they will be able to explain if they are or are not connected.

I do find that specialists like to focus on their own little fragment & often are not good at treating an entire person.

Is this picture the ranges or results? It’s looks like you have the range for FT4 but no result & result above for T4 but no range.

Hope you get answers at your appointment, let us know how you get on.

You may get more replies if you do a post with hurthle cells & mass in title. Then those with similar experiences or more knowledge can comment.

[Siren20 in reply to Siren20]

I’m going to see a surgeon on the 15th sooner if they can fit me in. The ENT said we need to wait for that outcome if we can do both biopsies at the same time then that’s better. Is this Layout better and yes peroxidase is correct!!! WTH!?! Thank you so much

Most recent blood test results

[Siren20 in reply to Siren20]

I have a thymoma next to my heart

[PurpleNails Administrator in reply to Siren20]

Sorry to hear this.

What are they planning next?

[PurpleNails Administrator]

You may want to edit image as your name and date of birth are visible.

[shaws Administrator in reply to PurpleNails]

To edit something on your post, click the down arrow next to More under your first post.

[Siren20 in reply to PurpleNails]

I hadn’t noticed thank you