Thyroid sonogram results

[lojo428]

I have been on synthroid or levothroid for hypothyroidism since age 14.  I am 44 years old.  Haven't been feeling well, so they did more blood work and a sonogram of my thyroid.  Hypothyroidism runs in our family and I have an Aunt who had Thyroid cancer and had her thyroid removed.  

My results are this:  right lobe is small, heterogeneous measuring 2.8 x 1.0 x 1.4 cm.  There is a poorly defined mixed echogenicity heterogeneous nodule in the lower pole measuring 8x5x4 mm.
Left Lobe:  The left lobe measures 3.8 x 1.0 x 1.2 cm.  the parenchyma is heterogeneous.  In the lower pole there is a hypechoic heterogeneous nodule measuring 9x5x6 mm.  In the mid polar region posteriorly, there is a 5x3x3 mm hypoechoic heterogeneous nodule.
Isthmus:  heterogeneous, measuring 3mm AP.  Impression:  Heterogeneous, multi-nodular thyroid lobes and isthmus as described.  The largest nodule is in the left lower pole measuring 9mm.  

My doctor just referred me directly to an endocrinologist to review these results, but I don't know what they mean.  Any help would be appreciated.  Thanks!

[lojo428]

Thank you so much for your reply!  It is so nice to get some feedback while waiting for the next appointment with the endo.  I just got another report back  from some blood work that they did which showed the TSI high at 243.  Does this change anything for you?  Once again, I really appreciate your time to respond here, it is greatly appreciated!  Lisa

[Mark Lupo, M.D.]

You have small nodules in the thyroid that are most likely inflammatory changes due to Hashimoto's Thyroiditis (the likely cause of your hypothyroidism).  Close attention via ultrasound to these nodules can help determine if there are any suspicious characteristics.  Your aunt's history may lower the threshold for FNA biopsy of the nodules, but in general we observe small nodule like this and then FNA if they increase in size.  The endocrinologist will hopefully be one who does ultrasound in his/her office to better classify the nodules and look for any other abnormalities (ie, lymph nodes) to clarify the situation.