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Thyroid ultrasound report showed thyroid gland enlarged. Diffuse heterogeneous echotexture noted. Suggest

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What does it all mean and what should be done next? I am a 56 year old female.
Thyroid ultrasound report:
Comparison: Thyroid ultrasound 05/17/2010
Findings: The right thyroid lobe measures 6.8 x 2.3 x2.7 cm, left lobe measures 6.3 x 1.7 x 1.6 cm, and the isthmus measures 0.6 cm AP dimension. Thyroid gland is enlarged. Diffuse heterogeneous echotexture is noted. The thyroid gland is mildly hypervascular on color Doppler images.

There is a 1.2 cm isoechoic solid nodule in the right mid thyroid. It is not identified with certainty on previous ultrasound. Three smaller 5 mm to 9mm solid/hypoechoic solid/cystic nodules are noted in the right upper pole and mid thyroid. The right mid thyroid nodule is stable compared to previous ultrasound.

The is a 1.2 cm hypoechoic, predominatly solid nodule in the left upper pole. It appears stable. Two 7-8 mm iso- to hypoechoic cysts/nodules in the left mid thyroid and lower pole appear stable.

Impression: Moderately enlarged thyroid gland. Diffuse heterogenous echotexture. Thyroid gland is relatively stable in size. Several cysts/nodules in right and left thyroid lobe compatible with multinodular goiter. A 1.2 cm isoechoic solid nodule in right mid thyroid is new compared to previous ultrasound. Few smaller 5-9 mm solid/cystic nodules in right and left lobes appear relatively stable. Thyroid gland is mildly hypervascular on Doppler images.

My blood tests and thyroid uptake and scan are normal.
Posted Mon, 8 Jul 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 53 minutes later
Thyroid nodules are fairly common, more so in women, and the majority are benign. If you do not have major risk factors for thyroid cancer such as past exposure to radiation to the neck area, a past history of thyroid cancer or a first degree relative with thyroid cancer, or suspicious looking nodules on ultrasound then the risk of these nodules being cancerous is low.

The characteristics you have shared in the thyroid ultrasound report do not suggest a worrisome picture of the nodules.
There is no need to worry about the cysts. Regarding the solid ones, it is mostly those greater than 1 cm in size that can be considered for biopsy, if at all. The one on the left seems stable.
It is useful to trend the growth pattern of these nodules over time

The above weblink helps endocrinologists track growth trends in thyroid nodules over time. An interval increase of more than 50% may indicate the need to intervene with one of the following options : 1 fine needle biopsy 2 repeat fine needle biopsy if one has been done in the past 3 referral for surgical removal of the nodule(s) or part or whole of the thyroid
But it is worth noting that even benign nodules grow

For more information on thyroid nodules, peruse this link:
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