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  • Nodule on right side and blood work

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    Old 05-09-2013, 03:37 PM   #1
    duckonrock
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    Join Date: May 2013
    Location: W Ny
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    Nodule on right side and blood work

    I am a 37 year old female with no known history of thyroid issues. I have been having very stressful times at work recently. The day after an extraordinarily stressful day, my husband noticed a big lump on the right side of my throat. I went to see my doctor immediately and he wanted me to have an ultrasound done on 4/9/2013. Ultrasound results suggested that I should have Fine-Needle Aspiration done on the right nodule. My blood work, ultrasound and FNA results are attached below. According to the FNA results it looks like the nodule grew from 4.6 cm (ultrasound) to 4.8 cm in less than 1 month.

    After reviewing the FNA results, my doctor wanted to see me again and was concerned about the size of the nodule. He was expecting the size to go down after the FNA as some of the liquid should have been drained out during the procedure. He said that Thyroid AB was slightly elevated otherwise is fine, biopsy looks fine but the size of the nodule is concerning. He wanted me to schedule an appointment with a surgeon who is specialized in Endocrine Surgery.

    I am trying to schedule an appointment with a surgeon now but am extremely concerned because not having diagnosis after the FNA is stressing me out greatly. Especially the information I read on the internet says that the FNA results should be able to tell the type of the nodule whether it malignant or benign. Also I am very curious as to why it appeared suddenly after a very stressful day. Can all this be related to my body having endured sudden and extreme amount of stress? Based on the test results and size of the nodule, does anyone here have an idea what type of nodule this is?

    Also, I am not sure if doctors respond to questions on this site. I would appreciate it if you could let me know of any other site to get a second opinion from specialists.

    Many thanks in advance for your help.

    Blood & Thyroid Tests

    Assessments: THYROIDNO, Lab: DHE-S, Name: DHE-S, Value: 309.6, Reference Range: 35.0-430.0 ug/dl
    Assessments: THYROIDNO, Lab: FRT4, Name: FREE T4, Value: 0.90, Reference Range: 0.65-2.30 ng/dL
    Assessments: THYROIDNO, Lab: TSH, Name: TSH, Value: 2.15, Reference Range: 0.40-4.00 uIU/ml
    Assessments: THYROIDNO, Lab: TotT3, Name: TOTAL T3, Value: 1.20, Reference Range: 0.75-1.78 ng/mL
    Assessments: THYROIDNO, Lab: Ferritin, Name: Ferritin, Value: 36.30, Reference Range: 15.00-275.0 NG/ML
    Assessments: THYROIDNO, Lab: Prolactin, Name: Prolactin, Value: 28, Reference Range: 3-17 ng/ml
    Assessments: THYROIDNO, Lab: Cortisol, Name: Cortisol, Value: 7.49, Reference Range: 5.00-20.00 ug/ml
    Assessments: THYROIDNO, Lab: Phosphorus, Name: Phosphorus, Value: 3.9, Reference Range: 2.5-4.5 mg/dl
    Assessments: THYROIDNO, Lab: Uric Acid, Name: Uric Acid, Value: 4.3, Reference Range: 2.5-7.0 mg/dl
    Assessments: THYROIDNO, Lab: Thyroid AB (ATA, TPO), Name: Thyroid Peroxidase AB, Value: 44, Reference Range: <35 IU/ml
    Assessments: THYROIDNO, Lab: Thyroid AB (ATA, TPO), Name: Thyroglobulin AB, Value: <20, Reference Range: <20 IU/ml
    Assessments: THYROIDNO, Lab: ESR,WESTERGREN, Name: ESR,WESTERGREN, Value: 4, Reference Range: 0-20 mm/hr
    Assessments: THYROIDNO, Lab: ESTROGENS,TOTAL,SERUM, Name: ESTROGEN, TOTAL, SERUM, Value: 733, Reference Range: pg/ml
    Assessments: THYROIDNO, Lab: TBII, Name: TBII, Value: <6.0, Reference Range: <=16.0%
    Assessments: THYROIDNO, Lab: LIPID, Name: CHOL, Value: 179, Reference Range: 0-200 mg/dL
    Assessments: THYROIDNO, Lab: LIPID, Name: TRIG, Value: 49, Reference Range: 0-150 mg/dL
    Assessments: THYROIDNO, Lab: LIPID, Name: HDL, Value: 55, Reference Range: 40-120 mg/dL
    Assessments: THYROIDNO, Lab: LIPID, Name: HDL RATIO, Value: 3.3, Reference Range: 1.0-3.0 %
    Assessments: THYROIDNO, Lab: LIPID, Name: VLDL, Value: 9.8
    Assessments: THYROIDNO, Lab: LIPID, Name: LDL, Value: 114
    Assessments: THYROIDNO, Lab:, CBC (INCLUDES DIFF/PLT)
    Name Value Reference Range
    WBC 7.0 3.8-10.8 Thous/mcL
    RBC 4.54 3.80-5.10 Mill/mcL
    HEMOGLOBIN 13.9 11.7-15.5 g/dL
    HEMATOCRIT 41.5 35.0-45.0 %
    MCV 91.4 80.0-100.0 fL
    MCH 30.7 27.0-33.0 pg
    MCHC 33.6 32.0-36.0 g/dL
    RDW 12.4 11.0-15.0 %
    PLATELET COUNT 227 140-400 Thous/mcL
    MPV 10.1 7.5-11.5 fL
    TOTAL NEUTROPHILS,% 65.1 38-80 %
    TOTAL LYMPHOCYTES,% 25.8 15-49 %
    MONOCYTES,% 4.8 0-13 %
    EOSINOPHILS,% 3.5 0-8 %
    BASOPHILS,% 0.8 0-2 %
    NEUTROPHILS,ABSOLUTE 4557 1500-7800 Cells/mcL
    LYMPHOCYTES,ABSOLUTE 1806 850-3900 Cells/mcL
    MONOCYTES,ABSOLUTE 336 200-950 Cells/mcL
    EOSINOPHILS,ABSOLUTE 245 15-500 Cells/mcL
    BASOPHILS,ABSOLUTE 56 0-200 Cells/mcL
    DIFFERENTIAL An instrument differential was performed.

    Ultrasound results:

    EXAM: Thyroid Sonogram
    HISTORY: Enlarged thyroid gland. Palpable right lobe nodule
    TECHNIQUE: Thyroid sonogram with grayscale and color flow Doppler imaging
    FINDINGS: The left lobe measures 4.6 x 1.4 x 1.4 cm. The right lobe measures 6.6 x 3.7 x 4 cm
    There is a right mid to lower pole mixed cystic soft tissue vascular nodule measuring 4.6 x 2.9 x 4 cm. No left lobe nodules demonstrated.
    IMPRESSION: 4.6 cm right lobe nodule is recommended for fine-needle aspiration.

    Cytology, Fine Needle Aspiration Results:

    COLLECTION DATE: 4/30/2013
    PUBLISH DATE: 5/1/2013
    CLINICAL INFORMATION: Complex cystic nodule with mild vascularity.
    SPECIMEN CONSISTS OF: FNA Thyroid, Right 4.8cm, 4 Diff-Quiks
    CYTOLOGIC INTERPRETATION:
    Adequacy Assessment: Thyroid, right lobe, nodule, 4.8 cm (ultrasound-guided fine needle aspiration):
    Pass #1: Inadequate 9:30 am #2. Inadequate 9:35 am #1: Inadequate 9:40 am #2. Adequate 9:45 am
    Formal Interpretation: Thyroid, right lobe, nodule, 4.8 cm (ultrasound-guided fine needle aspiration):
    Nodular goiter (Bethesda II/VI)
    Comment: Abundant thin watery colloid, chunks of thick colloid, cluster of macrophages and scattered follicles seen.

     
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    Old 05-10-2013, 04:31 AM   #2
    Reece
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    Re: Nodule on right side and blood work

    Seems like you might have hashimotos (if the doctor says you had antibodies)---and a mass/nodule that grew as large as the thyroid lobe on your thyroid lobe.

    This is not a healthy thyroid. It's grown out of control. The fna can't determine what such a large "nodule" is, because it only draws a small sample of cells. Most of your samples were inadequate, and that one pass just got a bit of information. Rarely does an fna give you a "diagnosis".

    Whether this is cancer or not (it likely isn't), it will likely need to be removed---sometimes these things grow crazy, and wrap themselves around the structures in your neck, and even into your chest and become more challenging to remove. You will find out what it is after the surgery. This is nothing deadly, it's not an emergency, but it will likely need to come out.

     
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    duckonrock (05-10-2013)
    Old 05-10-2013, 06:17 AM   #3
    duckonrock
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    Join Date: May 2013
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    Re: Nodule on right side and blood work

    Thank you very much for your reply. I want to have it removed asap. I am in the process of making an appointment with a surgeon and will update my status here just in case it may be helpful to someone else.

    Best

     
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