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What Does My PET Scan Report Indicate?
Question: I have been speaking to an oncologist on here regarding my recent PET scan ( i have multiple melanomas ) that revealed thyroid issues. I have had an ultrasound and a FNA yesterday but it has been my oncologist that referred me. If the results come back begin, what action if any should I take regarding the finding of these nodules . I am not familiar at all with the thyroid.
Here are my resulsts regarding the thyroid so far ( from an oncology persective )
Pet Scan revealed :
In the visualized aspect of the neck there is a focal area of intense hypermetabolic activity which appears to be possibily located in the upper aspect of the left lobe of the thyroid gland one located inferiorly measuring approximately 8 mm and another 4 mm in diameter. When the PET images are correlated with the CT no definite lymph node is seen. A lesion or abnormality cin the upper pole region of the left lobe of the thyroid can not be ruled out and further evaluated with an us is recommended. There are additional low density nodular structures noted in the left lobe of the thyroid gland and further evaluation of these nodules with the thyriouid us would be helpful. Otherwise no lymphadenopathy in the region onf the neck bilaterally.
Results from the US
Right thyroid is enlarged measuring 1.9 x1.5x5.6 cm. There are minimal areas of heterogeneous echogenicity within the right thyroid lobe. There is no evidence for dominant right thyroid lobe nodule
Left thyroid measures 1.4 x 1.9x 5.6. There are 3 complex nodules in the left thyrious lobe which from superior to infeiror measure .6 x .7 .7 x .9 and 1.1 x 1.7 cm . The superior and inferior noudle demonstrates increased vasculairty. In conjnection with the positive PET scan a FNA should be considered.
If the FNA shows this is benign - please can you tell me what if anything should do now ?
Brief Answer:
Incidentaloma
Detailed Answer:
Hi
Good day.
The finding of thyroid nodules in PET scan is called an Incidentaloma. This means that it is an incidental finding. However, the ultasound report shows 3 nodules and one of them is more than 1 cm in size. Any thyroid nodule more than 1 cm in size should be subjected to FNA. The 0.9 mm nodule also may require FNAC. You will also need a thyroid function test. If the TSH is suppressed, you may require a nuclear scan.
The absence of lymphnodes in ultasound and PET scan is quite reassuring.
Further management is based on FNA finding. If it is benign, then another Ultrasound should be done in 6 months to assess change in size and change in character. If no or negligible change in size or character, then another ultasound should be done after 1 year. If that too is okay, then the frequency of monitoring with ultasound can be done once every 2 years or so. Ofcourse the endocrinologist need to examine your neck area during each visit.
These kind of incidental nodules in many parts of body including Thyroid, adrenal glands etc are common after 40 years of age. These are picked up on routine CT scan or ultrasound or PET scans done for another reason. These are generally called as incidentalomas. However, once these are found, the endocrinologist's job is to see if they oversecrete or undersecrete hormones. So they arrange for blood works. The next task is to rule out cancer. To rule out cancer in thyroid, we do an ultrasound and FNA.
Please dont worry. Meet an endocrinologist and he will guide you. If you need further clarifications, please dont hesistate to ask me further.
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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