Not sure what he means by dimunition....but the loss of the central fatty hilum is sometimes a concerning feature seen on US, and FNA can help determine if this may be a suspicious node (make sure the FNA is sent for cytology AND Tg-washout). In the absence of increasing serum TG, there is not likely a need for routine CXR.
Thank You Doctor. My FNA is scheduled for this afternoon. I will ask about the TG Washout. Thanks for responding!
I had my FNA this afternoon. It was guided by US, and the pathologist were in the room. I inquired about TG Washout and the resident US person said once they determine if there is a problem with my l-nodes, they could schedule more tests. I explained that TG Washout should be done with this procedure and she referred me to the pathologist's in the room. The pathogist said they really don't do that- his explanation was that if the node is benign it is not needed, and if the node is not benign, they take it out. I explained that TG Washout would aid in the diagnosis - but he didn't think it was ever necessary. I was kind of disappointed.
BTW, this is at a large teaching hospital in Iowa.
Any suggestions on how I could encourage this in the future. ( If these test are benign, I have another FNA in 6 months.)
Thanks in advance!
The Iowa folks may want to read updated articles on lymph node FNA w/ Tg washout (at the same time).
Hopefully your testing comes out straightforward to help guide treatment/follow-up.
http://www.thyroid.org/professionals/publications/guidelines.html
--- cut/paste this link, click on nodule & cancer 2009 - page 11 addresses this issue of Tg washout (may be helpful for future patients).