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Had Sonography Of Thyroid. Results Showed Solid Nodule In Midpole, The Right Lobe Of Thyroid Gland Heterogeneous. What To Do?
Question: I recently had a sono of my thyroid. Results were 0.2x0.3 x 0.2 hypoechoic nodule in midpole. 2.9x2.1x1.6 cm predominantly solid nodule in the midpole, the right lobe of the thyroid gland is heterogeneous
Hello
thanks for your query.
Thyroid nodules are very common: They are found in 4%–8% of adults by means of palpation, in 10%–41% by means of US , and in 50% by means of pathologic examination at autopsy . The prevalence of thyroid nodules increases with age. The likelihood that a nodule is malignant is affected by a variety of risk factors. Malignancy is more common in nodules found in patients who are younger than 20 or older than 60 years of age than in patients between 20 and 60 years of age . Physical examination factors associated with increased likelihood of malignancy include firmness of the nodule, rapid growth, fixation to adjacent structures, vocal cord paralysis, and enlarged regional lymph nodes . In addition, a history of neck irradiation or a family history of thyroid cancer increases the risk that a thyroid nodule is malignant .
For a Solitary nodule.—Strongly consider FNA for (a) a nodule 1.0 cm or more in largest diameter if microcalcifications are present and (b) a nodule 1.5 cm or more in largest diameter if any of the following apply: (i) nodule is solid or almost entirely solid, or (ii) there are coarse calcifications within the nodule.
Consider FNA for (a) a nodule 2.0 cm or more in largest diameter if any of the following apply: (i) the nodule is mixed solid and cystic, or (ii) the nodule is almost entirely cystic with a solid mural component; or (b) the nodule has shown substantial growth since prior US examination.
FNA is likely unnecessary if the nodule is almost entirely cystic, in the absence of the above-listed features.
For Multiple nodules.—Consider FNA of one or more nodules, with selection prioritized on the basis of the previously stated criteria in the order listed above. FNA is likely unnecessary in diffusely enlarged glands with multiple nodules of similar US appearance without intervening normal parenchyma.
Thus, you would have to go for a biopsy of the lesions.
Based on the results, one of the following options would be chosen -
No treatment/"watchful waiting." If the nodules are not cancerous, you and your doctor may decide that no treatment is needed at this time. The nodules will be closely watched for any changes through frequent check-ups.
Thyroid hormone suppression therapy. Some doctors treat noncancerous nodules with levothyroxine, a synthetic form of the thyroid hormone thyroxine. The medical theory is that this drug signals the pituitary to produce less of another thyroid hormone responsible for thyroid tissue growth. (The pituitary is a small gland in the brain that controls the thyroid gland.) The goal of levothyroxine treatment is to shrink the thyroid nodules. Doctors and researchers are still studying if this treatment actually works to shrink nodules.
Radioactive iodine. Your doctor may use radioactive iodine to treat hyperfunctioning thyroid nodules and multinodular goiters. The radioactive iodine is absorbed into the thyroid gland, causing the nodules to shrink. Pregnant women and women trying to become pregnant should not undergo this treatment.
Surgery. Surgery to remove nodules is the best treatment for nodules that are cancerous, that cause symptoms (eg, are so large that they make breathing or swallowing difficult), and that are "suspicious" (ie, cannot be diagnosed as cancerous or noncancerous without being surgically removed and examined).
Please consult your physician at the earliest for proper steps.
Take care.
thanks for your query.
Thyroid nodules are very common: They are found in 4%–8% of adults by means of palpation, in 10%–41% by means of US , and in 50% by means of pathologic examination at autopsy . The prevalence of thyroid nodules increases with age. The likelihood that a nodule is malignant is affected by a variety of risk factors. Malignancy is more common in nodules found in patients who are younger than 20 or older than 60 years of age than in patients between 20 and 60 years of age . Physical examination factors associated with increased likelihood of malignancy include firmness of the nodule, rapid growth, fixation to adjacent structures, vocal cord paralysis, and enlarged regional lymph nodes . In addition, a history of neck irradiation or a family history of thyroid cancer increases the risk that a thyroid nodule is malignant .
For a Solitary nodule.—Strongly consider FNA for (a) a nodule 1.0 cm or more in largest diameter if microcalcifications are present and (b) a nodule 1.5 cm or more in largest diameter if any of the following apply: (i) nodule is solid or almost entirely solid, or (ii) there are coarse calcifications within the nodule.
Consider FNA for (a) a nodule 2.0 cm or more in largest diameter if any of the following apply: (i) the nodule is mixed solid and cystic, or (ii) the nodule is almost entirely cystic with a solid mural component; or (b) the nodule has shown substantial growth since prior US examination.
FNA is likely unnecessary if the nodule is almost entirely cystic, in the absence of the above-listed features.
For Multiple nodules.—Consider FNA of one or more nodules, with selection prioritized on the basis of the previously stated criteria in the order listed above. FNA is likely unnecessary in diffusely enlarged glands with multiple nodules of similar US appearance without intervening normal parenchyma.
Thus, you would have to go for a biopsy of the lesions.
Based on the results, one of the following options would be chosen -
No treatment/"watchful waiting." If the nodules are not cancerous, you and your doctor may decide that no treatment is needed at this time. The nodules will be closely watched for any changes through frequent check-ups.
Thyroid hormone suppression therapy. Some doctors treat noncancerous nodules with levothyroxine, a synthetic form of the thyroid hormone thyroxine. The medical theory is that this drug signals the pituitary to produce less of another thyroid hormone responsible for thyroid tissue growth. (The pituitary is a small gland in the brain that controls the thyroid gland.) The goal of levothyroxine treatment is to shrink the thyroid nodules. Doctors and researchers are still studying if this treatment actually works to shrink nodules.
Radioactive iodine. Your doctor may use radioactive iodine to treat hyperfunctioning thyroid nodules and multinodular goiters. The radioactive iodine is absorbed into the thyroid gland, causing the nodules to shrink. Pregnant women and women trying to become pregnant should not undergo this treatment.
Surgery. Surgery to remove nodules is the best treatment for nodules that are cancerous, that cause symptoms (eg, are so large that they make breathing or swallowing difficult), and that are "suspicious" (ie, cannot be diagnosed as cancerous or noncancerous without being surgically removed and examined).
Please consult your physician at the earliest for proper steps.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
This info I already researched myself online. My question to u was your feelings of these results, not for u to forward me a summary from the web
It would be premature to tell you my " feelings " , without a proper biopsy result.
It would just put you under undue strain.
I tried my best, to provide an overview of the management guidelines for the problem you are facing.
Without examining you, or biopsy of the nodules, it is impossible to tell you anything concrete, which you would definitely hold on to in your mind.
My job is to provide a comprehensive overview of the problem ( thyroid nodule in this case ) and the possible management strategies after the appropriate investigations.
That I have done.
I would not apologize if you found the reply inadequate, as I did my job, however, if you feel so, feel free to ask for a refund.
Am sure you can ask for another doctor to handle your query.
Regarding the rudeness of your reply, I would choose to ignore it, since I cannot do anything about it.
Be well.
It would just put you under undue strain.
I tried my best, to provide an overview of the management guidelines for the problem you are facing.
Without examining you, or biopsy of the nodules, it is impossible to tell you anything concrete, which you would definitely hold on to in your mind.
My job is to provide a comprehensive overview of the problem ( thyroid nodule in this case ) and the possible management strategies after the appropriate investigations.
That I have done.
I would not apologize if you found the reply inadequate, as I did my job, however, if you feel so, feel free to ask for a refund.
Am sure you can ask for another doctor to handle your query.
Regarding the rudeness of your reply, I would choose to ignore it, since I cannot do anything about it.
Be well.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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