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Old 03-21-2011, 05:39 PM   #1
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Red face U/S and Scan Results- Please Help Explain

Hi. I am 40 years old and have been having symptoms of a thyroid problem. Please bear with me as this post is long.
Went to dr. who sent me for bloodwork and a thyroid U/S. Bloodwork came back "normal," but I have not received the report from the dr. yet to let me know levels.

U/S Results:
The thyroid gland has a somewhat rounded shape and is slightly enlarged with a multinodular goiter. The right lobe measures 4.4 x 2.1 cm. the left lobe measures 4.7 x 1.8.
There is a small nodule with scattered calcifications and cystic spaces in the very bottom of the left lower pole measuring 1.4 x 0.9 x 0.9 cm. There is a homogeneous slightly hyperechoic nodule left upper pole anteriorly measuring
9 x 9 x 9 mm. There is an adjacent oblong homogeneous nodule measuring 1.9 x 0.9 x 1.3 cm. Small calcifications are scattered throughout the left lobe.
The right lobe contains multiple nodules as well. Solid nodule upper pole 2.1 x 2.9 x 1.9 cm. Solid nodule mid pole laterally 6 x 5 x 8 mm.
Impression:
Multiple nodules. Consider Nuclear Medicine Thyroid Scan as initial evaluation.

Uptake Scan Results:
The patient swallows a capsule with 13uCi of I-131. Calculated 4 hour uptake is 4.8 % which is slightly below normal. Calculated 24 hour uptake of 15.6 % is normal although lower limits of normal.
Impression:
Upright slightly reduces and may suggest mild hypothyroidism.
Thyroid Scan:
The patient is injected with 10.6 mCi of Tc-99m pertechnetate.
Her sonogram demonstrates multiple nodules. On the left the largest nodule is in the lower pole measuring 1.4 x 0.9 x 0.9 cm. On the right there is a large solid nodule mid to upper pole.
There is a large area of photopenia occupying the mid and upper pole of the right in the area of the large sonographic mass. Ultrasound guided fine needle aspiration is recommended. There is a questionable tiny photopenic defect left lower pole where there is a 1.4 x 0.9 cm calcification. Ultrasound guided aspiration is requested.
Impression:
Two areas of photopenia. The largest occurs on the right. Consider ultrasound guided aspiration of these findings.

Can anyone help me and explain what all of this means, please? I am scheduled for the FNA of the two areas this Friday and I am scared to death.......Thank you! I really appreciate any input you can give me.

Last edited by shan0507; 03-21-2011 at 05:55 PM.

 
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Old 03-22-2011, 04:50 AM   #2
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Re: U/S and Scan Results- Please Help Explain

Sounds like you have the very common, "multinodular goiter"---a lumpy bumpy enlarged thyroid. It's usually from thyroid disease. If there are larger more dominant nodules they usually do a needle biopsy to get more information of what kind of cells might be in there.

These are usually benign. After the fna, if everything is fine, they will watch it for growth and changes. You should also consider taking thyroid hormone, as it may help it shrink.

In the worst case, if you had to worry about thyroid removal, it's not usually a difficult surgery. I don't think you have to worry about cancer, but if you did (which you don't at this point), it's an easily treatable, and usually curable cancer, I had it over 6 years ago, and thankfully no worse for the wear.

 
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shan0507 (03-23-2011)
Old 03-23-2011, 06:13 PM   #3
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Question Re: U/S and Scan Results- Please Help Explain

First I would like to say thank you to Reece, as she set my mind at ease with the previous post she left for me. I am truly grateful!

Can someone please tell me what labs are to be done to test the thyroid function?

My dr. did labs a few weeks ago, I just received the results, and the only ones I see mentioned regularly on this board are:

Free T4-0.84 (Range 0.70-1.48)
TSH-1.736 (Range 0.350-4.940)

What do these numbers mean? I see they are all within the "normal range", so does that mean I have nothing to worry about? Should I ask the dr. to do additional testing? If so, what tests do I ask for?

This is so confusing for me and frustrating because I have not seen my dr since all these tests started, so everything I am finding out is on the internet (which can be good and bad).

I know I have my FNA of the two nodules on Friday and I am trying to get as much info as I can, because my dr. will be referring me to an endo to review the tests with them. Shouldn't she review the info w/ me first? If meds are eventually needed, will she prescribe them or do I have to wait for the endo?

Any advice or info that anyone on the boards can give me is sooooo appreciated. I have actually learned the most from reading the posts here. (The stuff on the internet scares the heck out of me!)

Good Luck and God Bless to Everyone!

 
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