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What Does The Following Ultrasound Report Indicate?

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Posted on Mon, 14 Sep 2015
Question: what is your opinion:

Findings: The right thyroid lobe measures 4.4 x 1.9 x 1.9 cm. There is a 1.0 x 0.8 x 0.6 cm heterogeneously hypoechoic nodule with internal vascularity in the superior portion of the right thyroid lobe. There is a 4 x 5 x 3 mm anechoic nodule also in the superior right thyroid lobe.
The left thyroid lobe measures 4.5 x 1.9 x 1.8 cm. There are two 3-mm anechoic lesions in the superior and mid portions of the left thyroid lobe. The thyroid isthmus measures 3 mm in thickness.
At the site of palpable mass in the anterior neck just to the right of midline, there is a 3.9 x 3.7 x 1.7 cm ovoid hypoechoic mass which may show some mild peripheral vascularity.
ULTRASOUND THYROID B SCAN &/OR REAL TIME 10 Aug 2015 @ 1212 CHILLICOTHE, OH VAMC CALLENDER XXXXXXX large mass CHILLICOTHE, OH VAMC 17273 ST. RT. 104, CHILLICOTHE 45601-0999


Impression:
Abnormality, attention needed.

1. 3.9 cm ovoid mass in the anterior neck just to the right of midline. The sonographic appearance is nonspecific and further evaluation with contrast enhanced CT neck is recommended. 2. Indeterminant 1 cm right thyroid nodule. Consider fine needle aspiration with histologic diagnosis or followup thyroid ultrasound in six months.
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Neck lump

Detailed Answer:
The neck swelling needs prompt evaluation. At first glance it does not seem to arise from the thyroid. However more detailed analysis such as with CT scan is required. I strongly recommend you see a general surgeon at your earliest opportunity. When I see someone like you in my practice I order the following tests in addition to a thorough physical examination: CBC,CMP,TSH,free T4. I also have them see a surgeon right away for assessment of the neck lump
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (13 hours later)
I attached the report on my labs. Also, I am waiting for a CT scan and ENT appointment for a biopsy. It seems they are in no hurry to schedule the appointments but I am concerned it needs immediate attention. Do you think this can wait a few weeks or should it be done immediately? I am using the VA Healthcare System and access is sometimes a problem.
doctor
Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Follow up

Detailed Answer:
I have reviewed the attached reports. Notably your TSH and Free Thyroxine are normal suggesting normal thyroid function.

As regards to how urgent it is, one can only know for sure based on physical examination. You will need to ask your doctor whether he finds this urgent, based on his/her findings on examination
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (48 hours later)
Considering the labs indicate normal thyroid function, does that mean there is an increased possibility the nodules are malignant?
doctor
Answered by Dr. Shehzad Topiwala (8 hours later)
Brief Answer:
Second follow up

Detailed Answer:
Well, overall the risk of thyroid cancer run a nodule in about 5 to 10%. It is lower when the TSH is low.

However, we are not sure if the other lump is of thyroid origin. Only further testing will reveal more about it's nature.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (15 hours later)
OK Doc, thank you very much for the information.
doctor
Answered by Dr. Shehzad Topiwala (25 minutes later)
Brief Answer:
You are welcome

Detailed Answer:
Best wishes
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Does The Following Ultrasound Report Indicate?

Brief Answer: Neck lump Detailed Answer: The neck swelling needs prompt evaluation. At first glance it does not seem to arise from the thyroid. However more detailed analysis such as with CT scan is required. I strongly recommend you see a general surgeon at your earliest opportunity. When I see someone like you in my practice I order the following tests in addition to a thorough physical examination: CBC,CMP,TSH,free T4. I also have them see a surgeon right away for assessment of the neck lump