Suggest Treatment For Thyroid Nodules

Posted on Tue, 14 Nov 2017

Question: thyroid nodule.

No calcification noted on report
went for doppler and said there was peripheral vascularity and a very small spot inside. does that confirm cancer

Answered by Dr. Mirjeta Guni (3 hours later)

Brief Answer:
About thyroid nodule;

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern.
Thyroid cancer is confirmed only by cytology.
There are some ultrasound characteristics (hypoechogenicity, microcalcifications, high vascularisation, taller than wider) that suggest to do cytology when they are present but ultrasound does not confirm cancer.
When two or more of the above mentioned characteristics are present, the chances to be malignant are higher.
You do have only one, so there is no need to worry.
Anyway, cytology has high sensitivity in diagnosing it.
Hope i have answered your query.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Mirjeta Guni (15 hours later)

Thank you so much for your quick response and your patience. I am suffering a great deal as I high bipolar disease and Im so scared for my husband's health. All I do is cry and can't eat or sleep. He has been thoroughly checked for enlarged lymphnodes and all are normal.

I want to know if you received the ultrasound report, I dont know if it went through.
What doctor said was he had predominately periphiral vascularity and a little spot inside.
Is that a very bad sign?

He has no family history
No symptoms
No radiation exposure

Only morbid obesity which is his doctor's biggest concern.

. Sorry for all the questions, please forgive me. I don't now how I'm going to make it through this week awaiting results. I am such a weak person. My husband is not worried a bit and he says hes just worried about me.

Answered by Dr. Mirjeta Guni (40 minutes later)

Brief Answer:
About thyroid nodule;

Detailed Answer:
Hello again,
I have gone through the interpretation of the ultrasound as the images cannot be visualized.

The nodule is not hypoechoic, does not have microcalcifications. These are the 2 most common characteristics suggesting for malignancy.

So, I would say there is no reason to get worried.

You should know that 1 in two individuals has thyroid nodules in a random ultrasound control and only 5% of them are malignant. So, thyroid nodules are very common in the population and the chances of malignancy are relatively low.

Wish him good health. Feel free to ask further.

Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (17 minutes later)

Oh Dr. Thank you for your patience with me. This is the last question I promise. 1. Does it seem taller than wider?
Is that small area of intranodular vascularity a very bad sign? The doctor said it was mostly peripheral and only a small spot inside, can some benign nodule have small intravascularity.
I cant thank you enough for answering so quickly and precisely. Kids a re home now and I have to do the act of being happy and its so hard.

Answered by Dr. Mirjeta Guni (19 minutes later)

Brief Answer:
About thyroid nodules;

Detailed Answer:
Hi again,

I can not understand from the images if it is taller than wider, as I told the images of the ultrasound attached are inconclusive.

Increased vascularity is the last characteristic suggesting for malignancy and usually is diffuse, not only a spot.

You should know that thyroid malignancy has a very good prognosis after thyroidectomy (in difference from other cancers) so even if you think the worse, please do not panic.

Until now the data are not worrisome (no capsular infiltration, no cervical lymph nodes, no more than 2 characteristics suggesting for malignancy).

I can understand that waiting for a cytology result is an extremely anxious situation but it is a routine procedure in our days as the thyroid nodules are very common.

Wish you all the best,
Dr.Mirjeta.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (11 minutes later)

Thank you so very much. I pray its Benign with all my heart, He is the most loving husband and father in the world. We are high school sweethearts.

I'm just really scared when I read about medullary and anaplastic types. ARe those common? Im sorry docotr how common are the anaplastic and medullary ones

Answered by Dr. Mirjeta Guni (8 hours later)

Brief Answer:
It is neither Medullary nor anaplastic;

Detailed Answer:
Hi again,
Medullary cancer has a different ultrasound image, microcalcifications are typical for it in ultrasound.
An aplastic is a diffuse cancer not nodulary and is very rare with a rapid enlargement of the gland ( within a few days).
So, do not think about none of them.
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Mirjeta Guni (6 hours later)

thank you so much doctor. I wish I could be strong and not have this disease. I wish I could have a normal mind. Thank you from the bottom of my heart

Answered by Dr. Mirjeta Guni (1 hour later)

Brief Answer:
Will be a pleasure to help you further;

Detailed Answer:
I am sure everything will be ok. There is no need do get worried in advance in our days, if smth serious is diagnosed than the concern is right, in this case there is really nothing to worry about. The worse thing will be the thyroid gland removal.
Keep me in touch for the result of the FNA.
Best wishes,
Dr.Mirjeta

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Above answer was peer-reviewed by : Dr. Vaishalee Punj