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What Does The Thyroid Ultrasound Report Indicate?
Question: I received the following ultrasound results...I'm very scared. Can you interpret? I'm having an FNA...I'm 35, Female. This is probably cancer?
Multiple thyroid nodules are present throughout the gland.
- The dominant nodule is a 2.2 x 1.1 x 2.1 cm heterogeneously echogenic partially cystic and solid nodule in the mid body of the right lobe with irregular margins. Coarse calcifications are associated with the cystic portion of the nodule, however bright
echogenic reflectors associated with the solid component are concerning for microcalcifications.
- Additional sub and peri-centimeter nodules are seen bilaterally. These include a 4 mm nodule in the inferior pole of the left lobe with mixed echogenicity and a 1 cm predominantly hypoechoic nodule in the midline isthmus with angular margins.These
likely represents colloid nodules.
No parathyroid nodule is identified.
There is no morphologically suspicious cervical adenopathy, however lymph nodes measuring up to 1 cm in the long axis are indeterminant.
Multiple thyroid nodules are present throughout the gland.
- The dominant nodule is a 2.2 x 1.1 x 2.1 cm heterogeneously echogenic partially cystic and solid nodule in the mid body of the right lobe with irregular margins. Coarse calcifications are associated with the cystic portion of the nodule, however bright
echogenic reflectors associated with the solid component are concerning for microcalcifications.
- Additional sub and peri-centimeter nodules are seen bilaterally. These include a 4 mm nodule in the inferior pole of the left lobe with mixed echogenicity and a 1 cm predominantly hypoechoic nodule in the midline isthmus with angular margins.These
likely represents colloid nodules.
No parathyroid nodule is identified.
There is no morphologically suspicious cervical adenopathy, however lymph nodes measuring up to 1 cm in the long axis are indeterminant.
Brief Answer:
Thyroid nodules
Detailed Answer:
I have reviewed your thyroid ultrasound report.
it is difficult to say if any of these are cancerous on the basis of the ultrasonographic characteristics alone. There are some features that are more benign looking while others are not.
The probability of cancer in the nodules is dependent on many other factors as well such as:
1 Family history of thyroid cancer
2 Exposure to upper body radiation for previous head/neck area cancer
3 Findings on FNA
4 Neck symptoms such as pain in neck; hoarseness of voice; change in voice; difficulty speaking/breathing/swallowing
FNA seems like a reasonable next step. When I see someone like you, I also order
CBC
CMP
TSH
first
Thyroid nodules
Detailed Answer:
I have reviewed your thyroid ultrasound report.
it is difficult to say if any of these are cancerous on the basis of the ultrasonographic characteristics alone. There are some features that are more benign looking while others are not.
The probability of cancer in the nodules is dependent on many other factors as well such as:
1 Family history of thyroid cancer
2 Exposure to upper body radiation for previous head/neck area cancer
3 Findings on FNA
4 Neck symptoms such as pain in neck; hoarseness of voice; change in voice; difficulty speaking/breathing/swallowing
FNA seems like a reasonable next step. When I see someone like you, I also order
CBC
CMP
TSH
first
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My CBC indicated mildly elevated platelets (405). And I have a sed rare of 38 and crp 1.8...both elevated. I also have suspected Dercums Disease. I thought the micro calcifications are definitely cancer? Plus the irregular margins?
Brief Answer:
Follow up
Detailed Answer:
The platelet elevation is not worrisome. The ESR and CRP are best handled by your internist. Dercums disease has no known association with thyroid nodules nor cancer.
There are half a dozen sonographic characteristics which are associated with the possibility of cancer. Microcalcifications and irregular margins are just 2 of them. Others include 'taller than wider ' nodule, solid, hypoechoic nodule and suspicious looking lymph nodes ('with loss of fatty hilum').
Many of these are too technical to understand for the non expert and are best left for the radiologist and endocrinologist to interpret.
It is not as if the presence of one of two of worrisome features suggests an extremely high risk of cancer. It only helps in choosing which nodule to FNA. This procedure gives a fair idea as to whether or not there is cancer in the nodule.
Follow up
Detailed Answer:
The platelet elevation is not worrisome. The ESR and CRP are best handled by your internist. Dercums disease has no known association with thyroid nodules nor cancer.
There are half a dozen sonographic characteristics which are associated with the possibility of cancer. Microcalcifications and irregular margins are just 2 of them. Others include 'taller than wider ' nodule, solid, hypoechoic nodule and suspicious looking lymph nodes ('with loss of fatty hilum').
Many of these are too technical to understand for the non expert and are best left for the radiologist and endocrinologist to interpret.
It is not as if the presence of one of two of worrisome features suggests an extremely high risk of cancer. It only helps in choosing which nodule to FNA. This procedure gives a fair idea as to whether or not there is cancer in the nodule.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you...I have a one year old little girl and I'm so scared. If a nodule is partially cystic and solid...does that indicate anything? If it is cancer...the nodule is large...does that mean it wasn't caught early?
Brief Answer:
Second follow up
Detailed Answer:
Partially cystic and solid does not significantly change the plan on the basis of this one feature. All above factors need to be taken into consideration for final decision making.
Large does not necessarily mean cancer. Nodules grow at variable speed and some may not grow at all
Second follow up
Detailed Answer:
Partially cystic and solid does not significantly change the plan on the basis of this one feature. All above factors need to be taken into consideration for final decision making.
Large does not necessarily mean cancer. Nodules grow at variable speed and some may not grow at all
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
One last question (for now)...what does the comment about the lymph nodes mean?
"There is no morphologically suspicious cervical adenopathy, however lymph nodes measuring up to 1 cm in the long axis are indeterminant."
Does the "up to 1 cm" and "interdeterminant" mean there may be something going on with those nodes?
"There is no morphologically suspicious cervical adenopathy, however lymph nodes measuring up to 1 cm in the long axis are indeterminant."
Does the "up to 1 cm" and "interdeterminant" mean there may be something going on with those nodes?
Brief Answer:
Third follow up
Detailed Answer:
It means that there are no lymph glands in the neck region in the vicinity of the thyroid that appear to have any characteristics on ultrasound that look suspicious for cancer.
However, the next comment by the radiologist reporting the ultrasound will need clarification, because (s)he goes on to make a general statement ....'however lymph nodes measuring up to 1 cm in the long axis are indeterminant'. What (s)he does not state is whether such lymph nodes are present in your neck or not.
The description that you have provided makes no mention of the presence of such lymph nodes. All one can learn from this comment is that lymph glands measuring upto 1 cm in a certain dimension cannot be labeled normal or abnormal with confidence, according to the radiologist reporting your Ultrasound.
Third follow up
Detailed Answer:
It means that there are no lymph glands in the neck region in the vicinity of the thyroid that appear to have any characteristics on ultrasound that look suspicious for cancer.
However, the next comment by the radiologist reporting the ultrasound will need clarification, because (s)he goes on to make a general statement ....'however lymph nodes measuring up to 1 cm in the long axis are indeterminant'. What (s)he does not state is whether such lymph nodes are present in your neck or not.
The description that you have provided makes no mention of the presence of such lymph nodes. All one can learn from this comment is that lymph glands measuring upto 1 cm in a certain dimension cannot be labeled normal or abnormal with confidence, according to the radiologist reporting your Ultrasound.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I very much appreciate your help. I just read that nodules with both coarse calcification and microcalcifications are more likely to be Medullary Thyroid Cancer. That's very scary. It said that there are coarse calcifications in the cystic part and micro in the solid??
Brief Answer:
Fourth follow up
Detailed Answer:
There are half a dozen sonographic characteristics which are associated with the possibility of cancer. Microcalcifications, coarse calcifications and irregular margins are few examples of them. Others include 'taller than wider ' nodule, solid, hypoechoic nodule and suspicious looking lymph nodes ('with loss of fatty hilum').
Many of these are too technical to understand for the non expert and are best left for the radiologist and endocrinologist to interpret.
It is not as if the presence of one or two of worrisome features suggests an extremely high risk of cancer. It only helps in choosing which nodule to FNA. This procedure gives a fair idea as to whether or not there is cancer in the nodule.
I would like you to please understand that Endocrinology/Thyroidology is one of the most complex fields of medicine. It takes one about 15 years of intense training to become an endocrinologist. So it is very difficult for me to explain everything to you on an online forum.
It is rather like me wanting to fly an airplane. No matter how many questions I ask a pilot I wont be able to fly a plane until I undergo extensive training.
Kindly bear this in mind.
I understand you are concerned about the risk of cancer, and the next several steps that your local endocrinologist will guide you through will hopefully provide definitive answers.
Fourth follow up
Detailed Answer:
There are half a dozen sonographic characteristics which are associated with the possibility of cancer. Microcalcifications, coarse calcifications and irregular margins are few examples of them. Others include 'taller than wider ' nodule, solid, hypoechoic nodule and suspicious looking lymph nodes ('with loss of fatty hilum').
Many of these are too technical to understand for the non expert and are best left for the radiologist and endocrinologist to interpret.
It is not as if the presence of one or two of worrisome features suggests an extremely high risk of cancer. It only helps in choosing which nodule to FNA. This procedure gives a fair idea as to whether or not there is cancer in the nodule.
I would like you to please understand that Endocrinology/Thyroidology is one of the most complex fields of medicine. It takes one about 15 years of intense training to become an endocrinologist. So it is very difficult for me to explain everything to you on an online forum.
It is rather like me wanting to fly an airplane. No matter how many questions I ask a pilot I wont be able to fly a plane until I undergo extensive training.
Kindly bear this in mind.
I understand you are concerned about the risk of cancer, and the next several steps that your local endocrinologist will guide you through will hopefully provide definitive answers.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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