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What Does My Thyroid Test Report Indicate?

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Posted on Tue, 3 Feb 2015
Question: The right lobe of the thyroid measures 4.80 cm x 1.30 cm x 1.30 cm. The left lobe measures 4.20 cm x 1.20 cm x 1.10 cm.
The isthmus measures 0.20 cm in width.
The thyroid parenchyma is heterogeneous and hypervascular.
There are numerous bilateral lymph nodes in the neck level 2 lymph node which is palpable in the right of 2.9 x 2.2 cm level 2-3 lymph nodes 2 cm and level 3 lymph node of 1.7 cm the left also demonstrates numerous lymph nodes palpable lymph node of 2.1 x 1.9 cm additional lymph nodes of 2.1 cm, 2 cm, 8 mm, 9 mm, 4 mm
Vascular flow on color Doppler is a hyper vascular.
IMPRESSION:
Heterogeneous hypervascular gland. Numerous bilateral anterior cervical lymph nodes what does all this mean?
doctor
Answered by Dr. Binu Parameswaran Pillai (2 hours later)
Brief Answer:
Thyroiditis

Detailed Answer:
Good day,
Noted your concern.

In this scan, the thyroid gland is enlarged with increased blood supply. there is heterogenous echotexture of thyroid paranchyma. They have not mentioned about any thyroid nodules. There are numerous lymphnodes. ALL THESE FINDINGS ARE usually indicates thyroiditis ( inflammed gland) either due to a infection or auto imunity.

You have only provided Ultrasound details. Please remember that ultrasound and other investigations are just supplementary tools and we need clinical details of the patient. What symptoms the patient have? Why was an ultrasound done? IS there an enlarged visible thyroid? Did the patient have fever, neck pain, tremors, palpitations, weight loss etc ?
What did the thyroid blood works show?

I hope you will reply with symptoms of the patient.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (56 minutes later)
Hello,
the symptoms are very fatigued and sore throat, it all started about three weeks ago it occured after patient had the flu. Patient has swollen nodes you can see. patient does not have strep. ultra sound was done two days ago. awaiting for blood results still. Patient was on Levaquin for 7 days 1xday 250mg. Patient had only slight improvement that levaquin finished up 8 days ago. Patient had other blood work done at end of November and everything was fine then. This started around the December 12. Neck pain patient has. Patient takes nasal spray at night with zyrtec to control allergies- been on that for about 4 years. Patient always has night sweats since a kid. but not to wet the sheets just enough to wake up too. When you say auto immunity, what diseases does that refer too? Please list them.

Also patient does not have thyroid nodules.
doctor
Answered by Dr. Binu Parameswaran Pillai (14 minutes later)
Brief Answer:
THYROIDITIS IS THE POSSIBILITY

Detailed Answer:
Thank you for the reply. The picture is much clear now. This is most likely a case of THYROIDITIS, from a viral infection. However, autoimmune thyroiditis ( HASHIMOTO's disease) needs to be excluded.

Even though the blood reports are still pending, it will likely show low TSH and elevated Free T4. To rule out autoimmunity, we need to do " Anti TPO". I hope a blood test called "ESR" was ordered by your doctor. In this case, ESR also will be elevated.

If the patient has neck pain, we can use pain killers like Paracetamol or Brufen. Occasionally steroids are required.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (9 minutes later)
The patient does have hashimoto hypothyroid disease but is being treated for it. Patient taking 41 mg of nature throid

From previous scans the thyroid is smaller than a year ago.
doctor
Answered by Dr. Binu Parameswaran Pillai (21 minutes later)
Brief Answer:
Thyroiditis flare up

Detailed Answer:
okay. In that case, this episode can be a flare up of auto immunity or due to viral infection. The gland is enlarged as there is sore throat and neck pain, it is better to use a pain killer like Brufen
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
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1438 Questions

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What Does My Thyroid Test Report Indicate?

Brief Answer: Thyroiditis Detailed Answer: Good day, Noted your concern. In this scan, the thyroid gland is enlarged with increased blood supply. there is heterogenous echotexture of thyroid paranchyma. They have not mentioned about any thyroid nodules. There are numerous lymphnodes. ALL THESE FINDINGS ARE usually indicates thyroiditis ( inflammed gland) either due to a infection or auto imunity. You have only provided Ultrasound details. Please remember that ultrasound and other investigations are just supplementary tools and we need clinical details of the patient. What symptoms the patient have? Why was an ultrasound done? IS there an enlarged visible thyroid? Did the patient have fever, neck pain, tremors, palpitations, weight loss etc ? What did the thyroid blood works show? I hope you will reply with symptoms of the patient. Regards Binu