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What Does Ultra Sound Of Thyroid Showing Piece Of Tissue Indicate?
Question: What does "piece of tissue" indicate on ultrasound of thyroid bed ..... Had TT for PTC last year. Can ultrasound tell if the tissue is thyroid left over from surgery or just regular tissue. The ultrasound was ordered because I had high thymoglobin ab. how does that happen with no thyroid or does that happen if you have an infection somewhere in your body? Curious as to what the term 'inferior lymph nodes' means because that was on the ultrasound report prior to TT. They were on the left side and that is where the piece of tissue is. I see my dr the end of May so curious to what all that means. I didn't have the IRA after surgery my TSH is good @.5. On 150 mcg synthroid. Do you think they'll do a wait see approach and do another ultrasound in 3-6 months or a biopsy to see what kind of tissue it is and if there is a cancer concern?
Brief Answer:
Thyroid
Detailed Answer:
I am sorry to learn about the cancer history.
1 High thyroglobulin antibody can have a couple implications.
One, it could be present even before surgery if you are probe to 'autoimmunity' ie your own defences destroying your thyroid gland making it incapable of producing adequate amounts of thyroid hormone. This would be particularly true in your case if thyroglobulin antibodies were tested before surgery, especially so if you were taking synthroid even before TT.
Secondly, they can interfere with the measurement of thyroglobulin levels in the blood. These levels are used as tumor markers in PTC and the aim is to keep them suppressed just like the TSH. Some labs use methods which have a shortcoming of giving falsely negative results of thyroglobulin levels when thyroglobulin antibodies are positive. Therefore, caution is required in such instances when one cannot rely on blood thyroglobulin levels as indicators of cancer either remaining behind or reoccurring.
2 Inferior lymph nodes on the left side before surgery would be relevant only if the radiologist commented that they appeared suspicious ie not benign. Further the surgeon would have typically looked at that report, and quite likely explored lymph nodes in the neck area during surgery, and addressed the ones that looked suspicious for cancer spread. This would have been told to you or provided to you in the final pathology report after surgery.
3 You have correctly surmised the approach to the 'tissue in thyroid bed' on the most recent ultrasound. It is difficult to definitively conclude on ultrasound whether the tissue is thyroid or not. So either a XXXXXXX uptake and scan, or an Ultrasound guided FNA would give a fair idea. Blood thyroglobulin levels, if present in significant amounts, will also give some idea and aid decision making
4 Your TSH can be further suppressed with higher doses of synthroid if deemed appropriate to do so by your endocrinologist, especially if you do not severe osteoporosis or irregular heart rhythm/coronary heart problem related chest pains.
Thyroid
Detailed Answer:
I am sorry to learn about the cancer history.
1 High thyroglobulin antibody can have a couple implications.
One, it could be present even before surgery if you are probe to 'autoimmunity' ie your own defences destroying your thyroid gland making it incapable of producing adequate amounts of thyroid hormone. This would be particularly true in your case if thyroglobulin antibodies were tested before surgery, especially so if you were taking synthroid even before TT.
Secondly, they can interfere with the measurement of thyroglobulin levels in the blood. These levels are used as tumor markers in PTC and the aim is to keep them suppressed just like the TSH. Some labs use methods which have a shortcoming of giving falsely negative results of thyroglobulin levels when thyroglobulin antibodies are positive. Therefore, caution is required in such instances when one cannot rely on blood thyroglobulin levels as indicators of cancer either remaining behind or reoccurring.
2 Inferior lymph nodes on the left side before surgery would be relevant only if the radiologist commented that they appeared suspicious ie not benign. Further the surgeon would have typically looked at that report, and quite likely explored lymph nodes in the neck area during surgery, and addressed the ones that looked suspicious for cancer spread. This would have been told to you or provided to you in the final pathology report after surgery.
3 You have correctly surmised the approach to the 'tissue in thyroid bed' on the most recent ultrasound. It is difficult to definitively conclude on ultrasound whether the tissue is thyroid or not. So either a XXXXXXX uptake and scan, or an Ultrasound guided FNA would give a fair idea. Blood thyroglobulin levels, if present in significant amounts, will also give some idea and aid decision making
4 Your TSH can be further suppressed with higher doses of synthroid if deemed appropriate to do so by your endocrinologist, especially if you do not severe osteoporosis or irregular heart rhythm/coronary heart problem related chest pains.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for such a thorough response. I was on levo for about a month before TT. Had hysterectomy when I was 21 with no HRT I also had thoracic surgery for precancerous lesions of stomach and esophagus so I got diagnosed with osteoporosis I couldn't take anything it's been a few yeRs since I've had that retested but at the time I was high risk for thoracic fracture and moderate for hip.
Other than these issues I am basically healthy or was. Now I am confused am I hypo or hyperthyroid I am gaining weight, thinning hair, sleep issues, night sweats, palpitation joint and upper back aches. My t3 is 62 (70-180). I haven't been to the Drs in a year but go at the end of May. Can I ask him to give me t3 hormone and will it help those symptoms which bother me more than the slight risk of cancer?
Other than these issues I am basically healthy or was. Now I am confused am I hypo or hyperthyroid I am gaining weight, thinning hair, sleep issues, night sweats, palpitation joint and upper back aches. My t3 is 62 (70-180). I haven't been to the Drs in a year but go at the end of May. Can I ask him to give me t3 hormone and will it help those symptoms which bother me more than the slight risk of cancer?
Brief Answer:
Follow up
Detailed Answer:
Get a DXA Bone Density test done at all 3 sites: 1 Lumbosacral spine 2 Distal third of radius of non dominant hand 3 Both femoral necks
T3 is not recommended by thyroid experts. Levothyroxine alone suffices. Checking TSH and free T4 is usually enough to know if the thyroid dose is adequate or not
Follow up
Detailed Answer:
Get a DXA Bone Density test done at all 3 sites: 1 Lumbosacral spine 2 Distal third of radius of non dominant hand 3 Both femoral necks
T3 is not recommended by thyroid experts. Levothyroxine alone suffices. Checking TSH and free T4 is usually enough to know if the thyroid dose is adequate or not
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
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