Question: Hello, I am a 46 y/o female with a history of Thymoma and Myasthenia Gravis. The Thymoma was removed and diagnosed in 2015. Thyroid nodules were identified on my CT scans that I have every 6 months and CT measurement of the Thyroid nodule was 1.9cm on the larger nodule and last CT was November 2016. I followed up recently with my PCP and ultrasound was ordered after TSH was elevated as follows: I do not under stand the Thyroid results. Please advise

Mar 15, 2017      4.27 uIU/mL
Apr 14, 2016      2.15 uIU/mL
Jun 18, 2015      1.62 uIU/mL
Mar 20, 2014      1.63 uIU/mL
Aug 06, 2010      1.02 uIU/mL
     
ULTRASOUND THYROID GLAND: Comparison none.
TECHNIQUE: Multiple ultrasound images of the thyroid gland were obtained.

FINDINGS: The right lobe measures 5.0 x 1.7 x 1.7 cm and appears heterogeneous with a small nodule in the posterior mid region measuring 7 x 9 x 6 mm. It appears isoechoic with peripheral flow. There is overall mild increased flow to the right lobe of the thyroid gland. The isthmus is thickened measuring 6 mm. No nodules are seen. Left lobe measures 5.8 x 1.7 x 1.7 cm and demonstrates a calcified nodule in the upper pole measuring 7 x 8 x 5 mm. A larger isoechoic heterogeneous nodule is seen in the lower pole measuring 2.7 x 2.4 x 1.7 cm. This does not appear to be hypervascular.

IMPRESSION:
1.
Two nodules are seen in the left lobe, small calcified nodule in the upper pole and a larger isoechoic but hypovascular nodule in the lower pole. The right lobe demonstrates a single small nodule in the mid region posteriorly without increased internal flow but there is peripheral flow.
2.
Thyroid gland is overall enlarged and heterogeneous with mild generalized increased color Doppler flow.