
Can This Be Cancer?

Posted on
Mon, 14 Sep 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team


Question : Can this be cancer?
Report
THYROID ULTRASOUND
History: Nodules
Sonographic evaluation was performed with images obtained in transverse and longitudinal
planes.
No prior thyroid sonograms are available for comparison.
The thyroid gland is not enlarged in size. The right thyroid lobe measures 4.4 x 2.0 x
1.8 cms. The left thyroid lobe measures 4.3 x 1.5 x 1.8 cms. The isthmus measure 0.30
cms in AP dimension.
There is a homogeneous appearance to the echotexture of the thyroid gland. No discrete
nodules or focal abnormalities are identified.
Sonographic images of the right lateral neck demonstrates an enlarged heterogeneous level
4 lymph node with absence of the normally seen central fatty hilum measuring 3.2 x 1.0 x
1.5 cm. An enlarged left lateral neck level 2 lymph node of unremarkable configuration and
morphology is also noted measuring 3.2 x 0.9 x 1.1 cm.
IMPRESSION:
Normal thyroid gland.
Enlarged abnormal appearing right lateral neck level 4 lymph node measuring 3.2 x 1.0 x
1.5 cm. Clinical correlation and follow-up is recommended..
Report
THYROID ULTRASOUND
History: Nodules
Sonographic evaluation was performed with images obtained in transverse and longitudinal
planes.
No prior thyroid sonograms are available for comparison.
The thyroid gland is not enlarged in size. The right thyroid lobe measures 4.4 x 2.0 x
1.8 cms. The left thyroid lobe measures 4.3 x 1.5 x 1.8 cms. The isthmus measure 0.30
cms in AP dimension.
There is a homogeneous appearance to the echotexture of the thyroid gland. No discrete
nodules or focal abnormalities are identified.
Sonographic images of the right lateral neck demonstrates an enlarged heterogeneous level
4 lymph node with absence of the normally seen central fatty hilum measuring 3.2 x 1.0 x
1.5 cm. An enlarged left lateral neck level 2 lymph node of unremarkable configuration and
morphology is also noted measuring 3.2 x 0.9 x 1.1 cm.
IMPRESSION:
Normal thyroid gland.
Enlarged abnormal appearing right lateral neck level 4 lymph node measuring 3.2 x 1.0 x
1.5 cm. Clinical correlation and follow-up is recommended..

I saw my family doctor this past Wednesday and she was not able to feel either lymph nodes and she said a node that big should be able to be felt. Just so you know I am overweight and have a slight fatty neck. Is this true? She also had another doctor come in to feel for them as well and he wasn't able to find them. I also smoked for 20 years but quit 3 days ago. I have no symptoms and feel completely fine. This was an accidental finding because I was sent to check my thyroid because 5 years ago they found benign nodules on my thyroid.
Brief Answer:
Deep cervical lymph nodes may not be palpable
Detailed Answer:
Hi
Welcome back
As I mentioned earlier, there may be superficial and deep lymph nodes. Deep lymph nodes may not be palpable, it could be picked up on ultrasound or Computed Tomography Scan (CT scan).
I suggested you to get a Fine Needle Aspiration Cytology (FNAC) done to clear our apprehensions. Smoking could be one of the factors for the enlargement of the neck lymph nodes.
Do not worry! There doesn’t seem to be any major issues. We just need to confirm our diagnosis through FNAC.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Deep cervical lymph nodes may not be palpable
Detailed Answer:
Hi
Welcome back
As I mentioned earlier, there may be superficial and deep lymph nodes. Deep lymph nodes may not be palpable, it could be picked up on ultrasound or Computed Tomography Scan (CT scan).
I suggested you to get a Fine Needle Aspiration Cytology (FNAC) done to clear our apprehensions. Smoking could be one of the factors for the enlargement of the neck lymph nodes.
Do not worry! There doesn’t seem to be any major issues. We just need to confirm our diagnosis through FNAC.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar


So you think that even the level 4 lymph node is probably due to inflammation? I have an appointment tomorrow with an ENT. Do you think they will repeat the ultrasound in office?
Brief Answer:
He may or may not repeat the ultrasound
Detailed Answer:
Hi
Thanks for writing back
1. The ENT specialist would re-examine your neck and he may advice for a repeat ultrasound.
2. Or else, if he believes the previous ultrasound report, then, he may suggest you to get a CT scan of the neck and the upper thorax along with FNAC of the lymph node.
Hope this clarifies your doubts. Good luck
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
He may or may not repeat the ultrasound
Detailed Answer:
Hi
Thanks for writing back
1. The ENT specialist would re-examine your neck and he may advice for a repeat ultrasound.
2. Or else, if he believes the previous ultrasound report, then, he may suggest you to get a CT scan of the neck and the upper thorax along with FNAC of the lymph node.
Hope this clarifies your doubts. Good luck
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar

Answered by

Dr. Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2545 Questions
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