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What Does The Following Ultrasound Report Indicate?
Question: Here are the results of my ultrasound of the neck with color doppler:
The thyroid gland measures as follows:
Right lobe = 5.4 x 1.8 x 2.2 cm
Left lobe = 5.8 x 2 x 2.3 cm
Isthmus = 0.41 cm thick
The thyroid parenchyma is heterogeneous in echo texture and exhibits a slight increase in vascularity. There is a fairly-defined heterogeneous hypoechoic ovoid focus in the right inter-polar region. It measures 0.69 x 0.63 x 0.5 cm, contains no calcification, and shows peripheral vascularity.
No enlarged or calcified lumph nodes appreciated in the anterior neck.
IMPRESSION:
Enlarged thyroid gland with diffuse parenchymal disease and right lobe solid nodule. No cervfical lymphadenopathy.
Can you please tell me what this means?
The thyroid gland measures as follows:
Right lobe = 5.4 x 1.8 x 2.2 cm
Left lobe = 5.8 x 2 x 2.3 cm
Isthmus = 0.41 cm thick
The thyroid parenchyma is heterogeneous in echo texture and exhibits a slight increase in vascularity. There is a fairly-defined heterogeneous hypoechoic ovoid focus in the right inter-polar region. It measures 0.69 x 0.63 x 0.5 cm, contains no calcification, and shows peripheral vascularity.
No enlarged or calcified lumph nodes appreciated in the anterior neck.
IMPRESSION:
Enlarged thyroid gland with diffuse parenchymal disease and right lobe solid nodule. No cervfical lymphadenopathy.
Can you please tell me what this means?
Brief Answer:
features of thyroiditis
Detailed Answer:
Good day,
Noted your concern. The ultrasound description is typical of thyroiditis which means that thyroid is inflamed and enlarged. It could be due to a viral infection or due to autoimmune disorder (hashimotos disease ).
There is a benign appearing small right thyroid nodule. Not to worry about it. If it was more than 1 cm, it would have required a needle biopsy.
It is worth checking following blood tests
a) Free T4 and TSH
b) Anti TPO
c) CBC, ESR
There is a chance of future hypothyroidism (under active thyroid ) due to thyroiditis.
Did you have any recent neck pain or flu like illness?
Regards
Binu
features of thyroiditis
Detailed Answer:
Good day,
Noted your concern. The ultrasound description is typical of thyroiditis which means that thyroid is inflamed and enlarged. It could be due to a viral infection or due to autoimmune disorder (hashimotos disease ).
There is a benign appearing small right thyroid nodule. Not to worry about it. If it was more than 1 cm, it would have required a needle biopsy.
It is worth checking following blood tests
a) Free T4 and TSH
b) Anti TPO
c) CBC, ESR
There is a chance of future hypothyroidism (under active thyroid ) due to thyroiditis.
Did you have any recent neck pain or flu like illness?
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Thank you for your reply. I am relieved that the nodule is nothing to worry about. I will get more tests as you requested.
I had been diagnosed with Hashimotos disease some 4 years ago after I went to a dermatologist because I suffered from allergies and hives for years wherein I had to take an antihistamine (Xyzal) every 4 days. My ANA tests proved positive and Anti-TPO were elevated. But all my thyroid tests were normal. The doctors do not think I have LUPUS.
But I got confused because one doctor wanted to treat me with steroids which another doctor flatly warned me not to take because he said they were steroids for athletes. So this other doctor gave me MEDROL but I could not even go up the stairs..I would be panting ...a scarey side effect of MEDROL. Another doctor said since all my thyroid tests.including my ultrasounds of the thyroid just showed thyroditis with no nodules..they decided to just wait and see. Now, in my online research, there was a lot of report that people like me get good results by taking a low dose of thyroid hormone.Then I was told that once I start thyroid hormone treatment that it would be difficult to stop.I also noticed that my thumbnails have ridges, my eyebrows are thinning and the sides of my tongue have ridges,all, according internet research, are signs of a failing thyroid regardless of what thyroid blood test results indicate.
So, since I am not guided well by any doctor, I, on my own, do follow up routine blood tests every 6 months. Last JULY 2014 here are some tests results...
TSH 1.19 ulU/ml (0.27-3.75)
FREE T4-RIA 18.74 pmol/L (11.5-23.0)
FREE T3-RIA 4.48 pmol/L (2.5-5.8)
So,after all these years, this last ultrasound indicated a nodule. It is the first time that a nodule has been seen. My question, would be what should I do to make this nodule disappear? Can it still change and become cancerous? I am so cautious with taking medication as I have become steadily more allergic to many things. I am allergic to hair XXXXXXX to dental anesthesia Lidocaine and mepivacaine...I am allergic to penicillin,and to food preservatives, and ibuprofen, and mefenamic acid..(I can only take paracetamol) and the list goes on...This is the first time I consult with a doctor online and I really hope I can be guided on how to solve this illness. I am 58 years old.,married and a mother of 3 grown children. I would love to still be alive to be able to enjoy my grandchildren.:)
Thanks in advance for all your help.And yes, Doctor, every now and then I have flu like symptoms. I ache all over and I feel tired. I usually feel tired and achy when I have less than 8 hours sleep. I do not have neck pain but I do sometimes have difficulty swallowing ..occasionally I have to remind myself to eat slowly and chew longer.
XXXX
Thank you for your reply. I am relieved that the nodule is nothing to worry about. I will get more tests as you requested.
I had been diagnosed with Hashimotos disease some 4 years ago after I went to a dermatologist because I suffered from allergies and hives for years wherein I had to take an antihistamine (Xyzal) every 4 days. My ANA tests proved positive and Anti-TPO were elevated. But all my thyroid tests were normal. The doctors do not think I have LUPUS.
But I got confused because one doctor wanted to treat me with steroids which another doctor flatly warned me not to take because he said they were steroids for athletes. So this other doctor gave me MEDROL but I could not even go up the stairs..I would be panting ...a scarey side effect of MEDROL. Another doctor said since all my thyroid tests.including my ultrasounds of the thyroid just showed thyroditis with no nodules..they decided to just wait and see. Now, in my online research, there was a lot of report that people like me get good results by taking a low dose of thyroid hormone.Then I was told that once I start thyroid hormone treatment that it would be difficult to stop.I also noticed that my thumbnails have ridges, my eyebrows are thinning and the sides of my tongue have ridges,all, according internet research, are signs of a failing thyroid regardless of what thyroid blood test results indicate.
So, since I am not guided well by any doctor, I, on my own, do follow up routine blood tests every 6 months. Last JULY 2014 here are some tests results...
TSH 1.19 ulU/ml (0.27-3.75)
FREE T4-RIA 18.74 pmol/L (11.5-23.0)
FREE T3-RIA 4.48 pmol/L (2.5-5.8)
So,after all these years, this last ultrasound indicated a nodule. It is the first time that a nodule has been seen. My question, would be what should I do to make this nodule disappear? Can it still change and become cancerous? I am so cautious with taking medication as I have become steadily more allergic to many things. I am allergic to hair XXXXXXX to dental anesthesia Lidocaine and mepivacaine...I am allergic to penicillin,and to food preservatives, and ibuprofen, and mefenamic acid..(I can only take paracetamol) and the list goes on...This is the first time I consult with a doctor online and I really hope I can be guided on how to solve this illness. I am 58 years old.,married and a mother of 3 grown children. I would love to still be alive to be able to enjoy my grandchildren.:)
Thanks in advance for all your help.And yes, Doctor, every now and then I have flu like symptoms. I ache all over and I feel tired. I usually feel tired and achy when I have less than 8 hours sleep. I do not have neck pain but I do sometimes have difficulty swallowing ..occasionally I have to remind myself to eat slowly and chew longer.
XXXX
Brief Answer:
Did you meet a rheumatologist
Detailed Answer:
Hi,
Thank you for the reply. Not to worry, I will try to guide you through keeping in mind the limitations of an online consultation
Let me explain. With the positive Anti TPO, you have hashimoto's thyroiditis. In thyroiditis, small nodules are common. The description in the ultrasound was of a benign nodule. Many small nodules may disappear, however, only time will tell if they will enlarge or not. Not to worry. Less than 1% of thyroid nodules are cancerous. Please repeat the ultrasound in 6 months time to compare the size and change.
At the moment, your blood results of Free T4 and TSH are perfect and you do not need any medicine for it. Taking low dose thyroxine will not influence the course of the disease in anyway . I would not suggest the same.
However, Anti TPO being positive, there is a high likelihood of you developing hypothyroidism in the future. Please repeat a Free T4 and TSH along with the ultrasound after 6 months.
MEDROL is a powerful steroid and in the long run, it can cause diabetes and muscle weakness. That could have been the reason why you felt unwell, on it. But I must say that it is a life saving drug when used for right indications by an experienced doctor.
With the body ache which you get every now and then, I would suggest to rule out Vitamin D deficiency. You may also need to consider doing stretch exercise and relaxation exercises to ease the body pain.
With the ANA being positive in the past, I was wondering if you met an immunologist or rheumatologist?
Did you meet a rheumatologist
Detailed Answer:
Hi,
Thank you for the reply. Not to worry, I will try to guide you through keeping in mind the limitations of an online consultation
Let me explain. With the positive Anti TPO, you have hashimoto's thyroiditis. In thyroiditis, small nodules are common. The description in the ultrasound was of a benign nodule. Many small nodules may disappear, however, only time will tell if they will enlarge or not. Not to worry. Less than 1% of thyroid nodules are cancerous. Please repeat the ultrasound in 6 months time to compare the size and change.
At the moment, your blood results of Free T4 and TSH are perfect and you do not need any medicine for it. Taking low dose thyroxine will not influence the course of the disease in anyway . I would not suggest the same.
However, Anti TPO being positive, there is a high likelihood of you developing hypothyroidism in the future. Please repeat a Free T4 and TSH along with the ultrasound after 6 months.
MEDROL is a powerful steroid and in the long run, it can cause diabetes and muscle weakness. That could have been the reason why you felt unwell, on it. But I must say that it is a life saving drug when used for right indications by an experienced doctor.
With the body ache which you get every now and then, I would suggest to rule out Vitamin D deficiency. You may also need to consider doing stretch exercise and relaxation exercises to ease the body pain.
With the ANA being positive in the past, I was wondering if you met an immunologist or rheumatologist?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Yes, I have seen rheumatologists, immunologists, and endocrinologists. I got so confused. Why so many specialists for thyroid problems?
Everybody had different methods of curing. Like I mentioned some wanted me to take steroids. Some said no steroids but just wait and see until thyroid "dies". Some said take low dose thyroxine. Some say taking thyroxine with normal thyroid tests will make me hyperthyroid.
This wait and see what happens I think is not wise. Something should be done to save my thyroid now, don't you think? I did not have nodules in past ultrasounds but now I already have. I feel frustrated.
And not one doctor requested for a Vit D test. Except you. I did take a vit D test on my own after researching about it and the normal was 30 and I was 20. I was deficient. So I bought some supplements and took a test again after 3 months. My D increased to 33. Then I stopped supplements for 3 weeks then took another test and I got deficient again at 25. Now I take supplements, again. It seems like Hashimoto sucks all your Vit d reserves. I also try to take some selenium as I read it is important.
I also took a sugar blood test ( on my own) HBAlc to test my sugar just last week.
Results: 5.4 (ref range 4.3-6.4) so I guess I am not diabetic.
Please , Dr. XXXXXXX there must be something I can do to stop the deterioration of my thyroid.
THANK YOU for your attention.
Yes, I have seen rheumatologists, immunologists, and endocrinologists. I got so confused. Why so many specialists for thyroid problems?
Everybody had different methods of curing. Like I mentioned some wanted me to take steroids. Some said no steroids but just wait and see until thyroid "dies". Some said take low dose thyroxine. Some say taking thyroxine with normal thyroid tests will make me hyperthyroid.
This wait and see what happens I think is not wise. Something should be done to save my thyroid now, don't you think? I did not have nodules in past ultrasounds but now I already have. I feel frustrated.
And not one doctor requested for a Vit D test. Except you. I did take a vit D test on my own after researching about it and the normal was 30 and I was 20. I was deficient. So I bought some supplements and took a test again after 3 months. My D increased to 33. Then I stopped supplements for 3 weeks then took another test and I got deficient again at 25. Now I take supplements, again. It seems like Hashimoto sucks all your Vit d reserves. I also try to take some selenium as I read it is important.
I also took a sugar blood test ( on my own) HBAlc to test my sugar just last week.
Results: 5.4 (ref range 4.3-6.4) so I guess I am not diabetic.
Please , Dr. XXXXXXX there must be something I can do to stop the deterioration of my thyroid.
THANK YOU for your attention.
Brief Answer:
Hashimotos thyroiditis can stop by itself
Detailed Answer:
SORRY FOR THE DELAY IN THE REPLY. I was travelling for last 2 days.
At the moment, your thyroid function is normal. Anti TPO is positive and there is a 30-40% chnace of you developing hypothyroidism in the future. There is no treatment we can do now to protect your thyroid against the autoimmune proces now. We just have to wait and monitor your thyroid functions.
Nodules are common during the thyroiditis process. Nodules form when the thyroid tisues desperately try to regenerate from the destructive process. Many a times small nodules settle and disappear later. We need to do another ultrsound after 6 months.
Vitamin D will drop if there is no sun exposure. If it is 33 now, you need to take daily dose of Vitamin D 2000 units a day. Sun exposure between 10 to 3 pm for atleast 15 minutes a day wil help to maintain the vitamin D levels.
Hashimotos thyroiditis can stop by itself
Detailed Answer:
SORRY FOR THE DELAY IN THE REPLY. I was travelling for last 2 days.
At the moment, your thyroid function is normal. Anti TPO is positive and there is a 30-40% chnace of you developing hypothyroidism in the future. There is no treatment we can do now to protect your thyroid against the autoimmune proces now. We just have to wait and monitor your thyroid functions.
Nodules are common during the thyroiditis process. Nodules form when the thyroid tisues desperately try to regenerate from the destructive process. Many a times small nodules settle and disappear later. We need to do another ultrsound after 6 months.
Vitamin D will drop if there is no sun exposure. If it is 33 now, you need to take daily dose of Vitamin D 2000 units a day. Sun exposure between 10 to 3 pm for atleast 15 minutes a day wil help to maintain the vitamin D levels.
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
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