Aa
Aa
A
A
A
Close
Avatar universal

Solid hypoechoic nodule on isthmus

Can I please get help interpreting? My insurance switched with a new system and my FNA was cancelled. Not sure how long until new one.

RIGHT THYROID: Measures 5.9 x 2.1 x 1.9 cm. There is heterogeneous echogenicity and normal
color Doppler flow. No significant discrete nodules.
LEFT THYROID: Measures 5.3 x 2.2 x 1.4 cm. There is heterogeneous echogenicity and normal
color Doppler flow. Mixed cystic and solid hypoechoic 1.3 x 1.3 x 0.7 cm nodule with punctate
echogenic foci mid left thyroid TR 4.
THYROID ISTHMUS: Measures 0.52 cm. Solid hypoechoic 1.4 x 0.6 x 0.4 cm nodule in the right
thyroid isthmus TR 4.
2 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Thank you for the information. I do have Hashimoto's. It runs in my family and my great-grandmother had thyroid cancer. Not sure which kind. I have been monitored off and on. It depends on the doctor. I will be following up this next week. I’m hoping to find a really good team of doctors with the insurance switch.
Helpful - 0
Avatar universal
The main concern from the ultrasound are the nodules.  Before I get to that, the heterogeneous echogenicity is often found in people with Hashimoto's or Graves diseases - do you have one of these thyroid autoimmune conditions?  (Heterogeneous echogenicity can also be caused by thyroiditis not caused by autoimmune condition.)

Most thyroid nodules are not cancerous.  90-95% of thyroid nodules are not cancerous.  FNAs are usually recommended when the size of the nodule is above 1.5-2 cm, which makes them more likely to be cancer, or sometimes when it is above 1 cm and has certain characteristics that make it more likely to not be benign, such as calcifications, mixed solid and cystic components, or hypoechoic texture.  This does not mean the nodule is cancerous, just that it is more likely than nodules without those characteristics, and further investigation needs to be done.  

I had a hypoechoic nodule that was around 1.3 cm, which was biopsied.  They gave me a 25% likelihood that is was cancerous after the ultrasound, and 33% chance after the biopsy (mine ended up being cancer, but that certainly does not mean yours will be cancerous, just that they need to look at it and decide what the best follow up is -- for example continue to watch by ultrasounds every 6 months to a year, or possibly thyroid surgery based on the FNA results).  I think they would probably want to do an FNA  on both the nodule on the isthmus and the one on the left lobe, since both are hypoechoic and one is partially cystic.

As for not knowing how long it will take to get an FNA - most thyroid cancers are slow growing, and doctors will often wait until a thyroid nodule gets to a certain size to even do a biopsy, even with more suspicious characteristics.  My thyroid surgery was scheduled for over two months after we got the biopsy results back, and the follow-up second thyroid surgery was scheduled for two months after the first, after I was diagnosed with papillary thyroid cancer.  So I don't think it is something you need to rush to do quickly, but it is also not something I would put off for a few months either (mostly because not knowing what the next step was with my thyroid treatment was much worse than actually being diagnosed with thyroid cancer, for me I get anxious about the unknown).

I hope this helps - at this point we can't really tell whether the nodules are benign or not until they do a biopsy, and only then can you start making decisions about what the next course of action is for the nodule.  Most solid nodules are benign, and even with more suspicious characteristics, there is still a good chance your nodules are benign, they just need further examination.

Good luck and take care,
Sarah
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.