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What does my ultrasound scan report indicate?

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Posted on Tue, 28 Mar 2017
Question: Need to understand location of cranial nerve in thyroid and if 2cm nodule could be causing ear, throat and sometimes head pain. Doctors say they are not related yet online forums full of people with the same symptoms.
Want to understand why symptoms getting worse, now 3 months after pregnancy, still breastfeeding. And what hormones might be making the pain worse. Read a paper on Chinese pregnant women who saw growth in existing nodules up to 3 months post partum and new nodules form during the time.
FNA non-diagnostic. Ultrasound suspect colloid cyst t has hypoechoic features. No other suspicious features: no calcification, no vascularity, has clearly defined edge, round shape. FNA getting repeated but seeking answers for above.
doctor
Answered by Dr. Mirjeta Guni (58 minutes later)
Brief Answer:
About postapartum thyroid problems:

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern!
The cranial nerves have a totally different location from thyroid.
Principal innervation of the thyroid gland derives from the autonomic nervous system. Parasympathetic fibers come from the vagus nerves, and sympathetic fibers are distributed from the superior, middle, and inferior ganglia of the sympathetic trunk. These small nerves enter the gland along with the blood vessels.
So, the head ache and ear ache can not be caused by the thyroid nodule.
During postpartum period, the thyroid is predisposed to autoimmune diseases (postpartum thyroiditis) and thyroid function and volume can change.
The nodule may get increased during pregnancy too.
So you should check also the thyroid hormones (TSH,FT4 and FT3) to evaluate the thyroid function. If they are altered, treatment should eb started.
About the nature of the nodule, you should wait the result of the second FNA.
Hope the information will help.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mirjeta Guni (1 hour later)
Regarding referred otalgia - See fig 15 and related commentary for this article:

http://www.yyyyyy.org/content/30/10/1817.full

This does not seem consistent with your response regarding the nerves? Can you clarify? The location of my nodule is right lateral isthmus and right lower pole of thyroid if relevant.

For the FNA - the first result was non-diagnostic and they only found colloid. If they only get colloid again will it still be called non-diagnostic or will they be able to call it benign?

Can post partum thyroiditis cause the ear and throat pain I am experiencing? The ultrasound reported normal thyroid size - would it have reported enlarged if thyroiditis?

I had those blood tests you mentioned earlier and am just awaiting results.

doctor
Answered by Dr. Mirjeta Guni (36 minutes later)
Brief Answer:
About thyroid pathologies:

Detailed Answer:
Hi again,
Advanced thyroid cancer that has infiltrated the adjacent structures may be a cause of otalgia but this is not your case.
A colloid nodule that has not invaded the thyroid capsule, can not be a cause of head ear ache.
If ultrasound shows a colloid cyst and the FNA verifies it, there is no chance of malignancy.
Regarding the thyroid function: an underactive thyroid can cause ear and head ache. You didn't describe the whole ultrasound report but only the coloidal cyst.
In most of the cases (but not always) the postpartum thyroiditis has some particular features in ultrasound.

Will be a pleasure to answer further questions.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2304 Questions

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What does my ultrasound scan report indicate?

Brief Answer: About postapartum thyroid problems: Detailed Answer: Hello and thank you for asking! I have gone carefully through your concern! The cranial nerves have a totally different location from thyroid. Principal innervation of the thyroid gland derives from the autonomic nervous system. Parasympathetic fibers come from the vagus nerves, and sympathetic fibers are distributed from the superior, middle, and inferior ganglia of the sympathetic trunk. These small nerves enter the gland along with the blood vessels. So, the head ache and ear ache can not be caused by the thyroid nodule. During postpartum period, the thyroid is predisposed to autoimmune diseases (postpartum thyroiditis) and thyroid function and volume can change. The nodule may get increased during pregnancy too. So you should check also the thyroid hormones (TSH,FT4 and FT3) to evaluate the thyroid function. If they are altered, treatment should eb started. About the nature of the nodule, you should wait the result of the second FNA. Hope the information will help. Kind regards, Dr.Mirjeta