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What does this ultrasound report of neck for thyroid indicate?

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Posted on Wed, 4 Feb 2015
Question: What does this mean?
CLINICAL INFORMATION: Goiter, unspecified. Neck swelling.

COMPARISON STUDY: None.

FINDINGS:

TECHNIQUE: Realtime ultrasonography of the thyroid gland was performed and static images obtained.


RIGHT LOBE: 5.2 cm x 1.5 cm x 1.7 cm. No discrete nodules.

LEFT LOBE: 4.6 cm x 1.5 cm x 1.4 cm.
Small solitary hypoechoic nodule seen along the mid to lower pole posteriorly measuring 6 mm x 4 mm
x 6 mm, nonspecific.

ISTHMUS: 0.3 cm in AP thickness.
Tiny echogenic nodule seen laterally on the right measuring 5 mm x 5 mm x 4 mm, nonspecific.

ECHOTEXTURE: Homogeneous.

VASCULARITY: Normal.

Focused imaging within the right lateral soft tissues of the neck demonstrate a few small mildly
prominent lymph nodes, the largest measuring 1.8 cm x 0.5 cm with echogenic fatty hilum. Small lymph
nodes are seen within the left lateral soft tissues of the neck, the largest measuring 1.4 cm x 0.4
cm with echogenic fatty hilum. These are nonspecific, likely reactive. These do not appear
pathologic by size criteria or morphology.


=====
IMPRESSION:

1. Normal sized thyroid gland with subcentimeter thyroid nodules within the left lobe and isthmus as
described which are nonspecific..

2. Small bilateral cervical lymph nodes, likely reactive.
I was worried about cancer such as lymphoma... These lymphs cannot be felt in my neck. Just wanted a second opinion.
Should I be worried abut these lymph nodes?
Forgot to mention I had a temp of 99.5 for a few days and on the day of ultra sound.l and have a mild sore throat .. Also very watery eyes that I practically have to peel open every morning because they are so crusty and sticky

doctor
Answered by Dr. Ajish TP (6 hours later)
Brief Answer:
No need to worry. These reports are normal

Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I have gone through your question and understand your concerns.

I will explain the report in detail

1. Ultrasound neck for thyroid

Thyroid is a small gland in neck that produce thyroid hormones, that is essential for normal functioning of the body. The ultrasound scan of thyroid is done to see if there are some significant nodules in thyroid.

Small thyroid nodules are seen in up to 20% (1 in 5) women of your age. So no need to worry seeing the nodules. Further evaluation of nodules is needed when:

a. Nodules are more than 10 mm
b. Nodules are more than 5 mm, but are 'suspicious of cancer' in ultrasound reports.

The usual further evaluation we do is FNAC (Needle biopsy) from the nodule.

Here the size of the nodule is less than 10 mm and are not suspicious. So no need of any further evaluation now. You can repeat an ultrasound after seeing a doctor 6-12 months later.

2. Ultrasound of lymph nodes

There are numerous lymph nodes that are normally seen in neck. There size increases when there is an injury or infection anywhere in head or neck. That means any thing from a scalp infection, teeth infection (caries), tonsillitis or thyroid infection (thyroiditis) can cause an enlarged lymph node. If it is due to this then it is called "reactive".

The lymphnode that require evaluation are:
a. Size more than 2 cm and persisting more than 1 month
b. Loss of fatty hilum (preserved in your case)
c. Abnormal structure of the node

None of these features are there in your scan. It is not lymphoma. So no need to worry. In your case probably the sore throat has resulted in this lymph node enlargement. If in doubt you can repeat the scan after 1 month.

Hope I have answered your query. If you have any further questions I will be happy to help
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Ajish TP (8 hours later)
What is the possibility that this small nodule is cancer and the lymph nodes that are enlarged have been effected by cancer? I know nothing is definite until a biopsy is done. just wanted your opinion . Thank you
doctor
Answered by Dr. Ajish TP (9 hours later)
Brief Answer:
It is unlikely to be cancer

Detailed Answer:
Hi XXXXXXX XXXXXX,

Welcome back.
I understand your concerns.

Don't worry. From the ultrasound findings these nodules are likely benign ( non cancerous). You can do an ultrasound guided FNAC ( needle biopsy) to confirm it.

The structure of lymph nodes in ultrasound is also looking benign.

The chance of developing cancer in the thyroid module is around 5%. That means most are benign. Thyroid cancers are slowly progressive, so even if you wait and watch, it won't affect you badly.

regards

Dr Ajish TP
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Ajish TP

Endocrinologist

Practicing since :2002

Answered : 819 Questions

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What does this ultrasound report of neck for thyroid indicate?

Brief Answer: No need to worry. These reports are normal Detailed Answer: Hi XXXXXXX Welcome to HCM. I have gone through your question and understand your concerns. I will explain the report in detail 1. Ultrasound neck for thyroid Thyroid is a small gland in neck that produce thyroid hormones, that is essential for normal functioning of the body. The ultrasound scan of thyroid is done to see if there are some significant nodules in thyroid. Small thyroid nodules are seen in up to 20% (1 in 5) women of your age. So no need to worry seeing the nodules. Further evaluation of nodules is needed when: a. Nodules are more than 10 mm b. Nodules are more than 5 mm, but are 'suspicious of cancer' in ultrasound reports. The usual further evaluation we do is FNAC (Needle biopsy) from the nodule. Here the size of the nodule is less than 10 mm and are not suspicious. So no need of any further evaluation now. You can repeat an ultrasound after seeing a doctor 6-12 months later. 2. Ultrasound of lymph nodes There are numerous lymph nodes that are normally seen in neck. There size increases when there is an injury or infection anywhere in head or neck. That means any thing from a scalp infection, teeth infection (caries), tonsillitis or thyroid infection (thyroiditis) can cause an enlarged lymph node. If it is due to this then it is called "reactive". The lymphnode that require evaluation are: a. Size more than 2 cm and persisting more than 1 month b. Loss of fatty hilum (preserved in your case) c. Abnormal structure of the node None of these features are there in your scan. It is not lymphoma. So no need to worry. In your case probably the sore throat has resulted in this lymph node enlargement. If in doubt you can repeat the scan after 1 month. Hope I have answered your query. If you have any further questions I will be happy to help With warm regards, Dr Ajish TP (MD,DM) Consultant Endocrinologist.