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Can This Be Cancer? Report THYROID ULTRASOUND History: Nodules Sonographic

Posted on Sun, 4 Oct 2020

Question: Can this be cancer?

Report

THYROID ULTRASOUND

History: Nodules

Sonographic evaluation was performed with images obtained in transverse and longitudinal

planes.

No prior thyroid sonograms are available for comparison.

The thyroid gland is not enlarged in size. The right thyroid lobe measures 4.4 x 2.0 x

1.8 cms. The left thyroid lobe measures 4.3 x 1.5 x 1.8 cms. The isthmus measure 0.30

cms in AP dimension.

There is a homogeneous appearance to the echotexture of the thyroid gland. No discrete

nodules or focal abnormalities are identified.

Sonographic images of the right lateral neck demonstrates an enlarged heterogeneous level

4 lymph node with absence of the normally seen central fatty hilum measuring 3.2 x 1.0 x

1.5 cm. An enlarged left lateral neck level 2 lymph node of unremarkable configuration and

morphology is also noted measuring 3.2 x 0.9 x 1.1 cm.

IMPRESSION:

Normal thyroid gland.

Enlarged abnormal appearing right lateral neck level 4 lymph node measuring 3.2 x 1.0 x

1.5 cm. Clinical correlation and follow-up is recommended..

Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
Could be an inflammatory lymph node...

Detailed Answer:
Hi

Thanks for posting the query

I have gone through the report thoroughly. I am of the opinion that the lymph nodes located on both the sides of the neck could be harmless inflammatory lymph nodes.

Lymph nodes in these region get enlarged when there is infection or inflammation in the oral cavity, nasal cavity, parotid gland, etc. The level 2 nodes in the neck could be either superficial or deep lymph nodes.

As the lymph node in the right side of the neck has lost it’s original texture, I would suggest you to get a Fine Needle Aspiration Cytology to confirm the chronic inflammation in the lymph node. Otherwise, the rest of your neck scan is absolutely normal.

Hope this answers your query; revert back to me if you have any follow-up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (9 minutes later)

I saw my family doctor this past Wednesday and she was not able to feel either lymph nodes and she said a node that big should be able to be felt. Just so you know I am overweight and have a slight fatty neck. Is this true? She also had another doctor come in to feel for them as well and he wasn't able to find them. I also smoked for 20 years but quit 3 days ago. I have no symptoms and feel completely fine. This was an accidental finding because I was sent to check my thyroid because 5 years ago they found benign nodules on my thyroid.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (40 minutes later)

Brief Answer:
Deep cervical lymph nodes may not be palpable

Detailed Answer:
Hi

Welcome back

As I mentioned earlier, there may be superficial and deep lymph nodes. Deep lymph nodes may not be palpable, it could be picked up on ultrasound or Computed Tomography Scan (CT scan).

I suggested you to get a Fine Needle Aspiration Cytology (FNAC) done to clear our apprehensions. Smoking could be one of the factors for the enlargement of the neck lymph nodes.

Do not worry! There doesn’t seem to be any major issues. We just need to confirm our diagnosis through FNAC.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (41 minutes later)

So you think that even the level 4 lymph node is probably due to inflammation? I have an appointment tomorrow with an ENT. Do you think they will repeat the ultrasound in office?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (7 minutes later)

Brief Answer:
He may or may not repeat the ultrasound

Detailed Answer:
Hi

Thanks for writing back

1. The ENT specialist would re-examine your neck and he may advice for a repeat ultrasound.

2. Or else, if he believes the previous ultrasound report, then, he may suggest you to get a CT scan of the neck and the upper thorax along with FNAC of the lymph node.

Hope this clarifies your doubts. Good luck

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar