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What does my lab test report indicate?

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Posted on Tue, 19 Sep 2017
Question: Right love of thyroid measures at 61x15x19mm with mildly heterogenous echotexture. Multiple modules identified including a mid pole hypoechoic solid nodule measuring at 3.6 x 4.5 x 3.5mm. Multiple small columns lower nodules identified at 5.1x2.9mm.

Left lobe of thyroid measures at 75x32x20mm. A mid to lower pole cystic nodule measures at 56x29x47mm with internal debris and peripheral vascularity. Suggestion if some nodularity is also seen within it.

Isthmus is thickened at 6mm.

No restosternal extension identified.

There is minor increase in vascularity in the right lobe of thyroid but otherwise no significant change is seen.

No significant deep cervical lymphadenopathy.

My doctor suggested to remove my whole thyroid. I am not sure should follow my doctor advise or not.

Please help.

ThanksJust for your information
- I had a fine needle aspiration on the large cyst on the left lobe, the result come back is: non diagnosis (catogories 1) - cyst content only.

- when the did fine needle aspiration last year, the drain almost all the cyst content. But now it grow back to the same size.

- my father pass away with cancer.
doctor
Answered by Dr. Mirjeta Guni (36 minutes later)
Brief Answer:
About thyroidectomy recommendation;

Detailed Answer:
Hello and thank you for asking!
Usually when the nodules are over 3 cm, they cause symptoms of adjacent structures compression such as: difficulty in swallowing or cough. In these cases thyroidectomy is mandatory.
Again, a nodule over 3 cm is still a criteria of intervention, because FNA has a high probability to be false negative but this is not your case.
Pure cystic nodules are of benign origin.
So, if the thyroid function ( TSH) is within the normal ranges, if you do not have symptoms of compression( mentioned above), if there is no risk of malignancy, if there is no tendency to increase in dimensions, the intervention may be skipped.
I do not know how your physician justified the recommendation for intervention but I am curios to know, why didn't he recommended it last year? What has changes now?
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Mirjeta Guni (49 minutes later)
Risk lobe of thyroid with mildly heterogenous echotexture and with a hypoechoic solid nodule measuring at 3.6x4.5x3.5mm. The terms they used; heterogenous echotexture and hypoechoic is that mean there is a risk of malignancy?

I had a blood test and my thyroid function ( TSH) is within the normal ranges, and i do not have symptoms of compression.

doctor
Answered by Dr. Mirjeta Guni (5 hours later)
Brief Answer:
About thyroidectomy indications:

Detailed Answer:
Welcome back,
The nodules of the right lobe are too small to be indicative for surgery. Even FNA is indicated when they are over 1 cm and have suspicious characteristics in ultrasound.
Furthermore they have the same dimensions as in the last year.
Anyway, I would recommend to discuss with your physician about pros and cons for intervention.
Best wishes,
Dr.Mirjeta Guni
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2399 Questions

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What does my lab test report indicate?

Brief Answer: About thyroidectomy recommendation; Detailed Answer: Hello and thank you for asking! Usually when the nodules are over 3 cm, they cause symptoms of adjacent structures compression such as: difficulty in swallowing or cough. In these cases thyroidectomy is mandatory. Again, a nodule over 3 cm is still a criteria of intervention, because FNA has a high probability to be false negative but this is not your case. Pure cystic nodules are of benign origin. So, if the thyroid function ( TSH) is within the normal ranges, if you do not have symptoms of compression( mentioned above), if there is no risk of malignancy, if there is no tendency to increase in dimensions, the intervention may be skipped. I do not know how your physician justified the recommendation for intervention but I am curios to know, why didn't he recommended it last year? What has changes now? Kind regards, Dr.Mirjeta