Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The Following CT Scan Of The Neck Indicate?
Question: Hi,
I am 66 years old male and was diagnosed with asthma three years ago. After taking asthma medication my respiratory problems were under control. However, recently I started having breathing problems again. This time the asthma medications did not help. CT of Neck indicated that thyroid glands had enlarged compressing trachea. Right lobe measured 7.5 x 2.4 x 2.1 cms, and left lobe was 7.5 x 2.8 x 2.4 cms, with small nodules measuring 2.2cms seen of both glands. Everything was within range in thyroid function test. The trachea is still straight and has not been bent either direction. My doctor suggested surgery to remove the glands. However, I am hesitant and want to know if there is any other non-surgical methods for my situation.
I am 66 years old male and was diagnosed with asthma three years ago. After taking asthma medication my respiratory problems were under control. However, recently I started having breathing problems again. This time the asthma medications did not help. CT of Neck indicated that thyroid glands had enlarged compressing trachea. Right lobe measured 7.5 x 2.4 x 2.1 cms, and left lobe was 7.5 x 2.8 x 2.4 cms, with small nodules measuring 2.2cms seen of both glands. Everything was within range in thyroid function test. The trachea is still straight and has not been bent either direction. My doctor suggested surgery to remove the glands. However, I am hesitant and want to know if there is any other non-surgical methods for my situation.
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
I have reviewed the attached CT scan report and images. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
USG of the neck and thyroid
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
USG is a better way to study the thyroid compared with CT scan, in most situations.
I often recommend fine needle aspiration biopsy of the thyroid nodules.
There are no effective non-surgical methods to improve your thyroid swelling. Radioactive iodine (radiation) has fallen out of favor as an option due to modest results.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
I have reviewed the attached CT scan report and images. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
USG of the neck and thyroid
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
USG is a better way to study the thyroid compared with CT scan, in most situations.
I often recommend fine needle aspiration biopsy of the thyroid nodules.
There are no effective non-surgical methods to improve your thyroid swelling. Radioactive iodine (radiation) has fallen out of favor as an option due to modest results.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
USG of Neck indicated, "Both thyroid lobes enlarged with heterogenous echotexture. Small nodules w/ small cystic areas sizing 10mm to 2.2 cos noted on right and unto 3.2 on left. Small calcifications seen. No tenderness and vascularity normal. No significantly sizable node." Rest were normal. Nothing out of normal was seen in Liver & Kidney function test as well as CBC. Vitamin D was slightly insufficient, 23 ng/mL. I have not done other tests on your list; biopsy has not been done as well. How safe is the surgery considering the fact that I am an asthma patient? How quickly should I have the operation done? Should the asthma be in total control before I go into operation?
Thanks for looking into this for me.
Thanks for looking into this for me.
Brief Answer:
Follow up
Detailed Answer:
I have read your description of the USG and other labs.
1 Safety of this surgery depends on pre-surgical assessment by an Anesthetic and general medical team of doctors who will run further tests on you as per their discretion and then decide regarding this.
2 Urgency of the operation depends on findings on physical examination by the thyroid surgeon. So an evaluation is required first by the surgeon
3 Whether or not the asthma needs to be in total control before surgery will be decided by your lung specialist (i.e Pulmonologist). Kindly consult one at the soonest
Follow up
Detailed Answer:
I have read your description of the USG and other labs.
1 Safety of this surgery depends on pre-surgical assessment by an Anesthetic and general medical team of doctors who will run further tests on you as per their discretion and then decide regarding this.
2 Urgency of the operation depends on findings on physical examination by the thyroid surgeon. So an evaluation is required first by the surgeon
3 Whether or not the asthma needs to be in total control before surgery will be decided by your lung specialist (i.e Pulmonologist). Kindly consult one at the soonest
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
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
