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Does Hashimotos Thyroiditis Develops Into Lymphoma?
Question: I have Hashimoto's Thyroid issue w/ a goiter. No hot spots have been seen, however, my goiter is difficult to feel, yet it clearly shows on an ultrasound or x-ray. I have been told Type 1 Diabetics develop thyroid issues that can subsequently turn to Lymphoma's due to the antibodies I make. With that being said, how often would you suggest a Thyroid ultrasound be performed? My current Endo doesn't seem concerned w/ having another ultrasound. So how will I know if it develops further w/ complications? TSH is running OK right now thanks to Synthroid 137mcg.
Brief Answer:
Thyroid
Detailed Answer:
A thyroid gland affected by Hashimotos thyroiditis rarely develops into a lymphoma but yes there is a slightly elevated risk for this condition in a hashimotos affected thyroid versus a normal one.
There are a few recommended ways to approach this:
1 Self Neck Checks
You can see your own neck in the mirror once a month or so to see if you notice any unusual swelling or lump in the thyroid area. Ask your doctor to show you where you can expect to see a thyroid related enlargement
If you ever notice it, bring it to the attention of your Endocrinologist.
This is particularly true If you see or feel a solid lump that seems fixed and immobile, and is associated with symptoms such as difficulty swallowing, breathing, speaking or hoarseness of voice.
2 Annual physical
During your quarterly/ semi annual or annual health check ups with your physicians you can request the doctor to examine your neck if they feel any nodules in the thyroid
3 Ultrasound is necessary only if there is suspicion on physical examination. For example, abnormal lymph glands are felt in the neck by your health care provider
However, palpation by hands and fingers is not 100% accurate and ultrasound is the most sensitive way to detect thyroid nodules. it is just not deemed cost effective to frequently do ultrasound scans for a rare condition.
Another key matter is what size are the nodules on your thyroid now?
Are they greater than 1 cm in size?
Does the radiologist think they have benign looking characteristics? Such as margins, echogenicity, height, width, calcifications, blood flow etc
Have you been advised to have a biopsy ever?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Topiwala,
Thank you for your prompt response. In answer to your questions, here are some ultrasound readings:
Findings: Diffuse heterogeneous thyroid echotexture with thyroid
gland lower limits of normal in size stable. Right lobe measures
3.8 cm long X 1.3 cm AP X 1.0 cm wide with left lobe measuring 3.4
cm long X 1.2 cm AP X 1.1 cm wide with 2 mm AP isthmus thickness.
No focal thyroid lesions visualized.
IMPRESSION:
1. Stable smaller size heterogeneous thyroid gland without focal
lesion consistent with chronic thyroiditis and/or treated subtle
multinodular goiter.
2. No cervical adenopathy visualized.
Those results were from 2011. Have not had another u-sound since 2011. No biopsy was suggested. I was just told, "We will keep an eye on it." Endocrinologist feels it is nothing to worry about now but feels down the road there could be something to worry about as he feels Type 1 Diabetics w/ Hashimoto's always develop w/ further complications or thyroid cancer.
This is very unsettling to me.
XXXX
Brief Answer:
Follow up
Detailed Answer:
The ultrasound is characteristic of Hashimotos appearance. There are no discrete nodules that merit evaluation for cancer. If you really are really concerned you may wish to get another ultrasound done now to see if any nodules have developed. If so, biopsy can be considered
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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