3mm nodule with suspcious calcification

[hollykokomo]

I had my left thyroid removed in 2015 because of a 4cm that after a NPB indicated it was suspicious for follicular cancer, the right side had a small nodule but because of size a NPB was not performed, and I opted for only my left side to be removed. The biopsy results were negative for cancer and my ENT has me set up for an ultrasound and a yearly TSH, I had my US and follow up 4/13 and the right side nodule is slightly bigger although still very small at 4mm but this time the US showed suspicious for calcification my MD suggested I have another US in 6 months and if it continues to grow then have NPB performed. My TSH level is normal although I am concerned b/c I work out 3/4 days a week but it is pretty intense, and I have always been able to lose weight with exercise routine but I am not able to lose one pound of 2 months of increased exercise and watching my diet with pretty detailed calorie intake. Should I see a endo MD, is a TSH enough, what would you advice on going forward with the NPB wait 6 months or do it now?


This discussion is related to Long term low iodine diet.

[hollykokomo]

Yes a FNA and a NPB is same, my ENT said yes they can perform a NPB/FNA on it at 4mm they do not typically unless it suspicious and mine was suspicious for calcification although because of size ENT said it was up to me. I do not see a endo I only have  been followed by my ENT, so far even with the left side of my thyroid being removed my TSH levels have been with in normal limits she only does a TSH level to monitor me. I am conflicted on if I should have the biopsy done or not. last year my right side had 1mm nodule that did not show calcification now its 4mm and shows it so it has changed and grown although still small. I am less worried because my left side was 4CM not mm and although it was suspicious for cancer the biopsy performed after it was removed was not cancer so I feel like this is prob the outcome if I go through with the NPB on my right. thank you for taking the time to give me your thoughts on this. I think I may ask my PMD to refer me to a endo and get their thoughts.

[898_1]

NPB is needle puncture biopsy which is same as FNA.  When one lobe is removed for tumors the best practice is to keep TSH suppressed to low normal value around 1.0
coarse or eggshell calcification is associated with benign nodules.

[WildMtn]

What is a NPB?  Is it similar to a FNA (fine needle biopsy)? If so, can they do that on something so small?  I have a 6mm nodule on the right, partially cystic, with some blood flow, and the possibility of calcification (it's pretty small, so hard to see).  Right now, I'm hyperthyroid and the game plan is to figure out first what the cause of that is, but most likely the nodule is going to take a backseat anyway, as it's small and we can watch and wait.