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Old 12-03-2004, 08:17 AM   #1
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curlyroller HB User
help understanding thyroid ultrasound results?

i need an endo to english translation please!!

i picked up a copy of my thyroid ultrasound write up this morning. could you guys PLEASE help me understand what the heck this all means? thanks so much.

here's the text from the report:

findings: the right lobe appears homogeneous in echogenicity and measures 6.72 x 2.38 x 2.15cm. there are two nodules that appear withing this lobe as follows:
located in the mid posterior pole, measring .69 x .52 x .43cm, complex.
located in the mid anterior pole, measuring .87 x 1.03 x .56cm, isoechoic.

the left lobe appears homogeneous in echogenicity and measures 6.73 x 2.43 x 2.72cm. there is a hypoechoic nodule that appears in the mid pole and measures 1.3 x .98 x .87cm.

the isthmus is normal at .48cm in thickness.

impression: enlarged thyroid gland with three nodules within it. findings consistent with multi-nodular goiter.

reccomendation: follow up in 6 months as clinically indicated.



what are these different nodule types: complex, hypoechoic and isoechoic? should i be concerned about them? what are the dimensions of a "normal" sized thyroid gland, i.e. how enlarged is my thyroid?


rachel.

 
Old 12-03-2004, 09:34 AM   #2
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Benzi HB User
Re: help understanding thyroid ultrasound results?

Call your endro and ask them to translate, The first time I saw my results and at the time a GP had ordered them, I took my little self off to a medical college (this is before the internet) and looked them up! I am not sure there is anyone here qualified to help you with this. Did your Doc give you med's? If you are any way uncomfortable with your results I would get a second opinion, I had to get not only a second opinion but a third and fourth opinion! In my case it was a good thing I did because, I did have cancer and on the first ultrasound it did NOT show up at all. I hate sometimes to tell this story because it may scare someone unnecessarly but it also could save a life!

 
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Old 12-03-2004, 03:01 PM   #3
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superstring HB User
Re: help understanding thyroid ultrasound results?

I agree with Benzi. Your endocrinologist should explain this to you. In fact, usually it's hard to extract a lab report from a lab or dr's office until the dr has spoken to the patient, just because they know that there is a good chance we (the patients) won't know what is being described & will freak out. Just so you don't freak out yet, just from my experience as a patient, I know that a complex nodule is partially solid & partially cystic (fluid filled), and hypoechoic would be not reflecting sound waves back on ultrasound (i.e., fluid filled), and isoechoic would mean reflecting sound waves back (i.e., solid). They didn't use these latter 2 terms in my ultrasound--I have a multinodular goiter also. My thyroid was not enlarged, less than 4 cm in largest dimension each lobe. I had a solid nodule in the left side, and a partially cystic nodule & a cyst on the right. I had a fine needle aspiration biopsy of the solid nodule and the partially cystic nodule. The partially cystic one came back benign, but the solid one came back with "atypical" cells. I saw 4 endocrinologists. All agreed that the probability of cancer was low, but not zero. The most experienced thyroid specialist recommended taking out the left side, the one with the solid nodule. I just had this surgery on 11/18/04. No big deal! I posted a summary yesterday under the title Surgery Survivor, if you are interested. No cancer found. I am to have another ultrasound in 3 months however, to follow the other side. It looks as if they are recommending that you have another ultrasound in 6 months & will see if anything has changed size. If I were you I would press for biopsy--my understanding is that this is standard for any solid nodule or partially solid nodule. I'm not an M.D., just a patient! But I did my research. BY the way, my thyroid hormone levels were normal. You didn't say what yours are, but they should be tested. Also helpful if the biopsy results are iffy or negative is what is called a thyroid scan & uptake--kind of an xray thing where they can determine if the nodule(s) is (are) functioning ("hot") or not ("cold)--cold nodules are more likely to be cancer than hot ones. Hope this helps! Let us know how it goes!

 
Old 12-03-2004, 04:45 PM   #4
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dogtired HB User
Re: help understanding thyroid ultrasound results?

what are these different nodule types: complex, hypoechoic and isoechoic? should i be concerned about them? what are the dimensions of a "normal" sized thyroid gland, i.e. how enlarged is my thyroid?


Hi Rachel
A complex nodule will have a mixed echo pattern meaning partly cystic,
partly solid or hemorrhage. Hypoechoic means no echos or a cyst
isoehoic means with echos but only slightly different from the surrounding
tisssue could be solid or hemorrhage. When they say the thyroid is
homogeneous that means an even tissue texture aside from the
nodules which is good. Your nodules are small and mulitple which is
also good.From my experience most docs consider a lobe over 4 cm
enlarged.Multinodular goiters are very common when nodules are over
2cm ,solitary and solid then you should have a biospy.I hope this
helped.

Also docs will use different terms
hypo and anechoic are the same and
iso and hyperechoic are the same.
Then some will make it easy by saying a cyst or a solid.

Last edited by dogtired; 12-03-2004 at 04:59 PM.

 
Old 12-03-2004, 04:48 PM   #5
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dogtired HB User
Re: help understanding thyroid ultrasound results?

Sorry Superstring I didn't read the other posts in this thread.

 
Old 12-03-2004, 05:05 PM   #6
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dogtired HB User
Re: help understanding thyroid ultrasound results?

Quote:
I did have cancer and on the first ultrasound it did NOT show up at
all.

That's too bad Benzi how long before the next ultrasound that did show
it? I guess you could chalk that up to three things an inadequate tech
a crappy machine or a bad interpretation.I'm sorry that happened to you.

 
Old 12-03-2004, 07:12 PM   #7
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superstring HB User
Re: help understanding thyroid ultrasound results?

Dear Dogtired: No apology necessary! Your answer covered ground that mine didn't, and I shied away from explaining "isoechoic" any further because I didn't know! By the way, my (solid) nodule was biopsied at the same time as the first ultrasound, I had had the scan which determined that it was "hot". The u/s revealed that it was 2.5 cm in largest dimension, & decision to biopsy was made at that point. I studied the heck out of it as much as I could, and although stats were in my favor (multinodular goiter, hot nodule) at some point I had to decide how much of a gambler to be. Probability of cancer with abnormal biopsy exceeded probabilities of complications/damage from surgery in my case. Bottom line was if I decided not to have surgery I should repeat ultrasound in 3-6 mos. And p.s. to curlyroller: Whatever your dr. recommends, I think that a second opinion (from a thyroid specialist) and even a third, fourth are in order. And the internet (with the qualification that you have to be fussy about what sites you study) is an incredible resource!

 
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