a bit concerned

[pelakey1]

Hi guys, haven't written for a while but just received some test alarming results, any feedback would be gratefully received, they measured the main nodule at 9mm 10 months ago

Study Result

Narrative

Clinical History :

Previously found to have oedema in the thyroid gland with associated it antithyroid antibody titre right suggestion of ultrasound at six months to determine whether there is any exacerbation of the inflammatory process

AN ADDENDUM HAS BEEN ENTERED AT THE END OF THIS REPORT

Ultrasound thyroid. *******THIS REPORT CONTAINS SIGNIFICANT and UNEXPECTED or URGENT FINDINGS******

The hypoechoic nodule previously mentioned within the lower right lobe of the thyroid appeared irregular today, measuring 22 x 8.5 x 7.8 mm. There appears to be some punctate calcification within this nodule today.

In addition there is a 6 mm area of microcalcification at the mid pole and an 11 mm hyper reflective nodule at the upper pole.

There is been little change in the global appearance of the thyroid gland since the previous study. This moves well on deglutition with no evidence of retrosternal extension.

It remains mildly enlarged with diffuse heterogenicity consistent with thyroiditis.

Within the left lobe there is a 23 mm isoechoic nodule and an 18 mm isoechoic nodule within the left isthmus.

There are 2 hypoechoic lymph nodes on the left level IV, neither of which appear to contain a hilum. One of these is adjacent to the left lobe of the thyroid and may represent and enlarged parathyroid. A PTH test is recommended.

Conclusion:

Previously mentioned hypoechoic nodule within the lower right lobe of the thyroid appears irregular and contains punctate calcification.

There are 2 hypoechoic lymph nodes on the left at level V needle with which contain hilar. One of these is adjacent to the left lobe of the thyroid may represent an enlarged parathyroid.

many thanks

[PurpleNails Administrator]

I’ll comment on points in the report. Hopefully it will explain a little more about the terms being used.

Ultrasound thyroid. *******THIS REPORT CONTAINS SIGNIFICANT and UNEXPECTED or URGENT FINDINGS******

This text is likely automatically added if further action or follow up required.

The hypoechoic nodule previously mentioned within the lower right lobe of the thyroid appeared irregular today, measuring 22 x 8.5 x 7.8 mm.

Hypoechoic mean denser tissue than expected.

measuring 22 x 8.5 x 7.8 mm, if this was 9mm 10 months ago then its grown significantly.

There appears to be some punctate calcification within this nodule today. This Is not an unusual finding studies show calcification in benign nodules and a slightly more common in cancerous findings.

In addition there is a 6 mm area of microcalcification at the mid pole and an 11mm hyper reflective nodule at the upper pole.

There is been little change in the global appearance of the thyroid gland since the previous study.

This moves well on deglutition. This mean it not affecting your swallowing.

No evidence of retrosternal extension. This means no downward growth of thyroid.

It remains mildly enlarged with diffuse heterogenicity consistent with thyroiditis. Swollen and damaged consistent with autoimmune damage, thyroiditis AKA hashimotos

Within the left lobe there is a 23 mm isoechoic nodule and an 18 mm isoechoic nodule within the left isthmus.

The isthmus is the joining tissue between the lobes. The left side has a nodule.

Isoechoic means of equal density to the normal surrounding tissues.

There are 2 hypoechoic lymph nodes on the left level IV, neither of which appear to contain a hilum.

Hilum or hilar is scar/marking attachment.

One of these is adjacent to the left lobe of the thyroid and may represent and enlarged parathyroid.

A PTH test is recommended.

You need A parathyroid hormone test, with calcium, phosphate, & vitamin D tested at same time. I think PTH need to be tested at the hospital where it is being tested, ie the sample need to be arranged to be tested quickly. Vitamin D can affect calcium which Is why it also needs to be tested. Often PTH is not tested until 2x overange calcium readings have appeared. It is not routinely tested.

They are concerned about your parathyroid. We have 4 parathyroid glands. They are small, pea-sized glands they are near to thyroid gland but has a completely different function. The parathyroid glands make parathyroid hormone which controls the levels of calcium and phosphorus in the blood. Parathyroid tumors are usually benign.

The Main symptoms of high blood calcium from hyperparathyroidism include:

* depression

* tiredness

* feeling thirsty and peeing a lot

* feeling sick and losing your appetite

* muscle weakness

* constipation

* tummy pain

* loss of concentration

* mild confusion

Conclusion:

Previously mentioned hypoechoic nodule within the lower right lobe of the thyroid appears irregular and contains punctate calcification.

There are 2 hypoechoic lymph nodes on the left at level V needle with which contain hilar. One of these is adjacent to the left lobe of the thyroid may represent an enlarged parathyroid.

[pelakey1 in reply to PurpleNails]

Thankyou for your detailed reply, it is much appreciated, I was most concerned about the rate of growth and the calcification and micro-calcification..

[pelakey1 in reply to PurpleNails]

I have done some more reading and the letter is confusing, it says microcalcification of 6mm.. but I read on an article that microcalcification are less than 1mm?? If that is correct then 6mm is a macrocalcification is it not?

[PurpleNails Administrator in reply to pelakey1]

The report doesn’t mention mAcro calcification. (They are specks bigger the >1mm, in thyroid) The report refers to a focused 6mm area of mIcro calcification. ie they are more concentrated in this area but each speck is micro. <1mm

I do not know If a concentration has any concerning indication.

I have a large (5cm) solitary nodule which grew 9mm in 7 months. It did settled down once I had anti thyroid medication, (it was hyper functioning). I’d had a FNA which showed it was benign, but was misinformed the thyroid function was normal didn’t come to light until I had 2nd scan.