Thyroid nodules & lymphadenopathy- no answers from doctors

08-06-2012, 12:49 PM

Hello all! I'm new to this forum & looking for advice. I went to my PCP after 1 year of swollen lymph nodes. I had a sonogram which revealed 1 small left-lobe thyroid nodule and >2 cm lymph nodes scattered about. In the 10 months since this sonogram, I have had other sonograms which have revealed >2 cm nodes mostly in my internal jugular chain and now I have 9 nodules, 6 on the right lobe with the largest being 12 mm. I have had "thyroiditis" for the past few weeks and after a Kenalog shot, a Medrol dose pack, prednisone 50 mg for 5 days and clindamycin - I am still having swelling and Pressure in my throat. Seeing as how my TSH and all labs are normal, with the exception of a slightly elevated ESR, my doctors are not acting terribly concerned and keep eanting to re-evaluate in 3-month increments. I am very uncomfortable right now and I am worried because I do not feel well, and I'd like to get the ball rolling. I've been on steroids 7 times and antibiotics 9 times in the last 10 months and I'm tired of being sick. I have seen an Immunologist, an Endocrinologist, and now an ENT. How do you suggest I proceed from here an is there anything I should be insisting that they do/check?

08-06-2012, 01:19 PM

I'm not sure on what's going on there but if you have thyroid nodules, over 1cm, you should have a needle biopsy--fna. You can also post your "normal" tsh, free t4 numbers with ranges and maybe people here can help you determine if they are affecting you,

I don't know the size of worrisome lymph nodes---they are also subject to texture as well---they could be biopsied if they are in the ranges of those issues---they might not be related to thyroid at all.

I think if it's possible, you might want to see a better ENT.

08-06-2012, 01:25 PM

Quote:

Originally Posted by Reece

I'm not sure on what's going on there but if you have thyroid nodules, over 1cm, you should have a needle biopsy--fna. You can also post your "normal" tsh, free t4 numbers with ranges and maybe people here can help you determine if they are affecting you,

I don't know the size of worrisome lymph nodes---they are also subject to texture as well---they could be biopsied if they are in the ranges of those issues---they might not be related to thyroid at all.

I think if it's possible, you might want to see a better ENT.

Most recent labs:
TSH 2.01
Total T3 112.43
Free T4 1.17
ESR 22

The largest of the thyroid nodules is 12 mm, and the lymph nodes are 2 cm+. I agree, a FNA is probably in order. They said I might just have a eutharoid goiter, but they don't know why it is as inflammed as it is right now other than "acute thyroiditis."

08-06-2012, 01:59 PM

Have you had anti-thyroid antibodies checked? They check for autoimmune thyroiditis (Hashimoto's). The more concerning I think are the prescence of numerous lymph nodes in your neck over 2 cm. Lymph nodes should not be bigger than 1 cm, and being adjacent to your thyroid, would be reason to take one out for a biopsy. I personally would see a surgeon who could do the FNA of thyroid nodules and a node biopsy in one procedure. It may be, depending on the size of your gland, that it should come out, if you have a large goiter. The ultrasound normally provides measurements of the total gland size as well as each lobe.

Thyroid nodules & lymphadenopathy- no answers from doctors

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