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Having Hashimoto, Inhomogeneous Parenchyma Thyroid Gland Lymphnodes, Nodules In Thyroid Lobes. Taking Synthroid. Related?

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Posted on Mon, 20 May 2013
Question: Hi I'm an American living in Shanghai and did my annual Thyroid Ultrasound here. I have Hashimoto's and have been taking Synthroid daily for almost 2 years. The thyroid sonogram reads :

Both thyroid lobes have normal size and contour with inhomogeneous parenchyma. The right thyroid lobe measures 10X13 mm. The let thyroid lobe measures 12 X 13 mm. Isthmus is normal measuring 2 mm. There are multiple hypoechoic solid nodules, the largest one in the right lobe measures 4X3 mm in middle portion, and the largest one in the left lobe measures 6X5 mm at the middle portion. No XXXXXXX vascular flow are detected within these nodules.

There are several lymphnodes in the neck region, the largest one of 5X5 mm in the right neck region and the largest one of 5X4 mm in the left neck region, likely reactive.

Impression: Inhomogeneous parenchyma thyroid gland, several small solid nodules in bilateral thyroid lobes? Several reactive enlarged lymph nodes in neck region. Suggest clinical correlations and follow exam in 6 months and thyroid functional blood test for further evaluation if clinically indicated.

They had me very worried and made me contact my doctors in the US for a comparison scan but noone will tell me anything other than they are watching it for 6 mths. Chinese medicine is a little frightening.
Thanks XXXXXX
doctor
Answered by Dr. Rahul Tawde (4 hours later)
Dear XXXXXXX
Thanks for writing in. You need to get Fine needle aspiration cytology of thyroid nodules and lymph nodes to rule out malignancy. If FNAC is suspicious better to undergo surgery - your doctor will be be able to decide on the need for surgery based on FNAC. If FNAC report is suggestive of benign etiology then regular follow up with Ultrasound every 6-12 months is necessary. Needless to say you have to get thyroid function tests atleast every 6 months if not more frequent. So further course will depend on the cause of the nodules whether its benign or malignant.
Hope this helps
Shivaprasad
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Having Hashimoto, Inhomogeneous Parenchyma Thyroid Gland Lymphnodes, Nodules In Thyroid Lobes. Taking Synthroid. Related?

Dear XXXXXXX
Thanks for writing in. You need to get Fine needle aspiration cytology of thyroid nodules and lymph nodes to rule out malignancy. If FNAC is suspicious better to undergo surgery - your doctor will be be able to decide on the need for surgery based on FNAC. If FNAC report is suggestive of benign etiology then regular follow up with Ultrasound every 6-12 months is necessary. Needless to say you have to get thyroid function tests atleast every 6 months if not more frequent. So further course will depend on the cause of the nodules whether its benign or malignant.
Hope this helps
Shivaprasad