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    Old 03-11-2011, 08:18 AM   #1
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    Thyroid Scan -- seems inconclusive

    Hi all,

    I had a thyroid scan yesterday (which, by the way, was virtually painless and easy!), and it seems that the results might not be terribly helpful. Via an earlier ultrasound (2/1/11), I discovered that I have a relatively small nodule (1.2x1.0x0.7cm) as well as other smaller nodules on my thyroid. The radiologist who reviewed the ultrasound wrote that my thyroid gland is diffusely heterogeneous and multinodular in appearance; she also noted twice that my thyroid is not enlarged.

    My doctor originally ordered a thyroid uptake and scan, but decided to cancel the uptake when she learned that I would need to stop my levothyroxine for ~7days (112 mcg). When I arrived yesterday for my scan, the technologist confirmed that we would only do the scan, and that they would "try" the thyroid scan (given that I was still taking my medication, presumably she meant that it might not be a useful/successful scan). So, after the scan, the radiology resident came out to palpate my lower neck; she could not locate the nodule mentioned earlier. She also noted that she couldn't see it on the very crude image produced by the thyroid scan. Given that I was still taking my rx, should I take comfort in the fact that the resident didn't see anything (presumably that means no hot spots or cold spots), or could the results be skewed due to my levothyroxine?

    What do you think the next logical step is for testing, given your experience? Another ultrasound? A biopsy? Or simply observing any changes over the next 6 months or year? If it matters, I'm a 31 year old male, and have been taking levothyroxine (slowly increasing dosages) for the past ~2 years. Unfortunately, I don't have any TSH, etc. results to include with this posting.

    Would appreciate any thoughts, suggestions...


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    Old 03-11-2011, 08:40 AM   #2
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    Re: Thyroid Scan -- seems inconclusive

    I think you should never ever listen to anything a resident says . When I had my thyroid work done, I had one tell me such ridiculous things that the attending I told just shook her head, and said "don't listen, you are fine".

    If there is still a dominant nodule over 1cm, you should consider getting an FNA. If they can't find it (it sounds strange that they can't, sometimes these things come and go, but sometimes different equipment can provide different results), then I would come back in 3-6 months and keep watching for growth/changes. I would also consider having the nodule itself monitored by an ENT or a good endocrinologist--mine has an ultrasound in his office, and does an fna on the spot if he sees anything large enough to biopsy.

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