So Confused! Lab results Normal - Large cold nodule - High uptake scan

[Christy_M]

I recently went to the doctor because of blood pressure issues (I've had this for years) when my doctor noticed a nodule on my thyroid.  My blood test results came back normal:

T4, Free (Direct ) 1.33ng/dL                 range: 0.82 - 1.77
TSH                 1.520uIU/mL range:  0.450 - 4.50
Triiodothyronine (T3) 152ng/dL                 range:  71 - 180

My u/s indicated a large cold nodule 3.4 cm x 2.1 cm x 2.4 cm.  The 24-hour uptake was 37%, normal 15-30% (hyperthyroid range).  I had the biopsy yesterday so I still need the results.  

I am sooo confused.  I'm having symptoms of hyperthyroid but if TSH levels are okay, what does this mean?  Also, if the biopsy results come back benign, should I still have the nodule removed?  Any help would be sincerely appreciated!!

[blsdnsvd]

There is always a positive side to a negative. It was caught and it can be removed.
Once the thyroid is removed, you will be relieved in knowing that you do not have to go through the u/s and biopsies again.

I too, had a multinodular goiter and one of the nodules were "cold" and "solid"....went through two years of u/s and biopsies and had a TT in dec of 09. Due to the size and cells that were in the nodule, i was told to take it out and i did. My results were benign, however i am relieved that it is out!....

Be sure to educate yourself and you will be fine. You are definitely not alone.

[Christy_M]

Got a call from Dr's office today.  Biopsy result came back as papilliary carcinoma.  Waiting to hear from surgical oncologist to schedule thyroidectomy....ugh.  Still in shock...

[898_1]

the Uptake is not that high (some labs have normal range up to 40%)
The elevated uptake with normal labs  indicates iodine defficiency (rare in the US, unless low iodine diet is observed) or recovery period after the thyroiditis.
if that nodule is palpable (solid); has blood flow in it and calcifications and if it grows rapidly, removal may be a good idea.
If nodule is the cyst, it can be drained and /or treated with ethanol scleroterapy.

[laura1967]

Hi there. Yes your labs look great! But has anyone ran thyroid autoimmune tests on you yet for Graves and Hashimoto's? You can have symptoms of these long before the lab ranges start showing.
ALso...try to be patient and wait for your biopsy results. I know it is hard.  :)
Your nodule is pretty large.....if the Dr wants to take it out, listen to him.  :)