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What Does The Following Ultrasound Report Indicate?
Question: I recently had an ultrasound done on my neck after a visit to my family physician. I am 63yr old female.
The radiologist report of the ultrasound shows the isthmus measurers 3.3 mm and the right lobe measuring 1.2 x 1.4 cm. There is evidence of hypoechoic changes noted within the right lobe of the thyroid measuring 0.6 x 0.3 cm and 0.3 x 0.2 cm. The left lobe of the thyroid measures 4.0 x 1.6 x 1.6 cm. It is moderately heterogeneous. There is evidence of a hypoechoic nodule measuring 5.4 x 2.0 x 4.5 mm . there is suggested evidence of calcification. There is evidence of bilateral cervical lymphadenopathy. There is the suggestion of a localized complex fluid collection in the area of the right sternoclavicular joint.
My physician ordered a nuclear uptake scan at our local hospital. When I went to schedule, I was informed there machine is broken and will have to be replaced. They are unable to give me a time frame for replacing it. When I contacted my physician's office I was told that I just needed to wait until they can replace it.
Is the result of the ultrasound minor that I do not need to worry or should I look elsewhere for a place to have the scan done?
The radiologist report of the ultrasound shows the isthmus measurers 3.3 mm and the right lobe measuring 1.2 x 1.4 cm. There is evidence of hypoechoic changes noted within the right lobe of the thyroid measuring 0.6 x 0.3 cm and 0.3 x 0.2 cm. The left lobe of the thyroid measures 4.0 x 1.6 x 1.6 cm. It is moderately heterogeneous. There is evidence of a hypoechoic nodule measuring 5.4 x 2.0 x 4.5 mm . there is suggested evidence of calcification. There is evidence of bilateral cervical lymphadenopathy. There is the suggestion of a localized complex fluid collection in the area of the right sternoclavicular joint.
My physician ordered a nuclear uptake scan at our local hospital. When I went to schedule, I was informed there machine is broken and will have to be replaced. They are unable to give me a time frame for replacing it. When I contacted my physician's office I was told that I just needed to wait until they can replace it.
Is the result of the ultrasound minor that I do not need to worry or should I look elsewhere for a place to have the scan done?
Brief Answer:
Thyroid
Detailed Answer:
The standard approach nowadays in individuals found to have a thyroid nodule is to first check a blood test for TSH. This does not require fasting and can be done at any time of day or night.
If the TSH is below normal, only then does the person need to be subjected to a Nuclear uptake and scan.
Otherwise, the endocrinologist and the patient need to discuss the plan of action jointly as to which is the next best step from the following:
1 Monitor the thyroid nodule in the left lobe over time with an Ultrasound annually or more/less frequently
2 Perform an UGFNAB (Ultrasound Guided Fine Needle Aspiration Biopsy) of the nodule considering it shows calcifications and there are lymph nodes present.
3 Proceed to thyroid surgery
It is extremely unlikely that the 'localized complex fluid collection in the area of the right sternoclavicular joint' has anything to do with the thyroid.
Moreover, it would be nice if the radiologist could comment further on the ultrasound report findings of 'bilateral cervical lymphadenopathy' and mention if the nodes have benign features or look abnormal. This helps decision making.
Furthermore, when I see someone like you in my practice I also assess the risk of thyroid caner by asking the following questions:
1 Has anyone in your family had thyroid cancer?
2 Have you ever been exposed to upper body radiation for other head/neck cancers or as part of treatment for acne/zits?
3 Do you have any difficulty in
breathing
speaking
swallowing
or do you have any pain in the neck
or do you have any change in voice/ hoarseness?
Thyroid
Detailed Answer:
The standard approach nowadays in individuals found to have a thyroid nodule is to first check a blood test for TSH. This does not require fasting and can be done at any time of day or night.
If the TSH is below normal, only then does the person need to be subjected to a Nuclear uptake and scan.
Otherwise, the endocrinologist and the patient need to discuss the plan of action jointly as to which is the next best step from the following:
1 Monitor the thyroid nodule in the left lobe over time with an Ultrasound annually or more/less frequently
2 Perform an UGFNAB (Ultrasound Guided Fine Needle Aspiration Biopsy) of the nodule considering it shows calcifications and there are lymph nodes present.
3 Proceed to thyroid surgery
It is extremely unlikely that the 'localized complex fluid collection in the area of the right sternoclavicular joint' has anything to do with the thyroid.
Moreover, it would be nice if the radiologist could comment further on the ultrasound report findings of 'bilateral cervical lymphadenopathy' and mention if the nodes have benign features or look abnormal. This helps decision making.
Furthermore, when I see someone like you in my practice I also assess the risk of thyroid caner by asking the following questions:
1 Has anyone in your family had thyroid cancer?
2 Have you ever been exposed to upper body radiation for other head/neck cancers or as part of treatment for acne/zits?
3 Do you have any difficulty in
breathing
speaking
swallowing
or do you have any pain in the neck
or do you have any change in voice/ hoarseness?
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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