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Solid thyroid nodule found on US
Hello ! A new member here.
In 2019 they found this nodule on US for something else, it was 5mm. In 2020 by the US report it was 8x4x6 mm , hypoechoic no microcalcification no internal vascularity , inferior pole. Low risk. In 2021 it was the same size , no microcalcification, mild internal vascularity, no interval changes , low risk . In 2022 the last US report says the nodule is heterogeneous 10x4x11 mm involving the mid pole of the left lobe, partially isoechoic partially hypoechoic, wider than tall, well-circumscribed no microcalcification. Solid or almost completely solid , smooth margin. Echogenic foci : none or large comet-tail artifacts. The isthmus was 3 mm unremarkable and the lobes are both homogeneous.
The recommendation for this TIRADS 4 is: FNA if bigger than1.5 cm and Follow up if bigger than 1cm. My Dr. wants to do FNA even if it is not bigger than 1.5 cm.
Is this nodule too small for FNA ? I'm scared of the procedure and the results as well. Don't have blood work done. No symptoms and I don't take any medications. No family history.
Thank you in advance !
In 2019 they found this nodule on US for something else, it was 5mm. In 2020 by the US report it was 8x4x6 mm , hypoechoic no microcalcification no internal vascularity , inferior pole. Low risk. In 2021 it was the same size , no microcalcification, mild internal vascularity, no interval changes , low risk . In 2022 the last US report says the nodule is heterogeneous 10x4x11 mm involving the mid pole of the left lobe, partially isoechoic partially hypoechoic, wider than tall, well-circumscribed no microcalcification. Solid or almost completely solid , smooth margin. Echogenic foci : none or large comet-tail artifacts. The isthmus was 3 mm unremarkable and the lobes are both homogeneous.
The recommendation for this TIRADS 4 is: FNA if bigger than1.5 cm and Follow up if bigger than 1cm. My Dr. wants to do FNA even if it is not bigger than 1.5 cm.
Is this nodule too small for FNA ? I'm scared of the procedure and the results as well. Don't have blood work done. No symptoms and I don't take any medications. No family history.
Thank you in advance !
I am not sure what Fna is but you may want to get a CT scan of it. I would see a specialist.
mkh9
mkh9
Hi zuszsu68,
I'm just seeing this now, so I'm sorry if your doctor has already addressed this question. As far as being scared of the procedure and the results: most thyroid nodules are benign, and thyroid nodules below the size threshold of 1.5 cm are much more likely to be benign, hence the recommendation guidelines. Certain characteristics can make a nodule more suspicious for cancer (this does not mean it is cancer, just that cancer is more likely and therefore an FNA at a smaller size threshold might be recommended). Based on your ultrasound, I would think that the partial hypoechoic nature of the tumor is what is prompting a recommendation for an FNA at a smaller size (hypoechoic texture on an ultrasound is more suspicious than isoechoic texture).
I know 4 people in my personal life (including me, 1 is me, 1 is a friend, 1 is my aunt, and 1 is my mom) who have had FNAs for thyroid nodules. (My result was suspicious for a neoplasm, I ended up having my thyroid removed. My friend's was malignant, he had this thyroid removed. Both my mom and aunt had benign nodules.) Thyroid cancer is very slow growing, and my cancerous thyroid nodules were diagnosed before they spread outside my thyroid, which meant I did not need radioactive iodine treatment. I had three nodules about 1-1.3 cm in diameter that were cancerous. My friend's nodule was over 2cm, and the cancer had spread outside of the thyroid, which meant a much more invasive surgery for him and radioactive iodine treatment (over 2cm doesn't automatically mean it has spread, it just becomes more likely the bigger it gets).
I know the idea of an FNA sounds scary. Thyroid cancer, especially if you are young, or if it is caught at an early stage, is incredibly treatable, and if it were me, I would opt for getting an FNA on the smaller nodule, just to make sure it is benign, rather than wait another year for another ultrasound. The procedure itself can be painful, but for me, the anxiety of not knowing whether my nodules were cancerous or not was more stressful than the pain from the FNA.
I hope this helps, and I'm sorry you have to deal with this too. My mom's thyroid nodules were found at a recent ENT appointment for something unrelated, and because of her family history, we were concerned. Thankfully, hers came back benign. I didn't want her to have to go through the FNA and possibly a thyroid cancer diagnosis like me, but I also wanted her to get tested to make sure that it wasn't anything she needed to worry about, and if it was something to worry about, we could make sure she got the treatment she needed.
I'm just seeing this now, so I'm sorry if your doctor has already addressed this question. As far as being scared of the procedure and the results: most thyroid nodules are benign, and thyroid nodules below the size threshold of 1.5 cm are much more likely to be benign, hence the recommendation guidelines. Certain characteristics can make a nodule more suspicious for cancer (this does not mean it is cancer, just that cancer is more likely and therefore an FNA at a smaller size threshold might be recommended). Based on your ultrasound, I would think that the partial hypoechoic nature of the tumor is what is prompting a recommendation for an FNA at a smaller size (hypoechoic texture on an ultrasound is more suspicious than isoechoic texture).
I know 4 people in my personal life (including me, 1 is me, 1 is a friend, 1 is my aunt, and 1 is my mom) who have had FNAs for thyroid nodules. (My result was suspicious for a neoplasm, I ended up having my thyroid removed. My friend's was malignant, he had this thyroid removed. Both my mom and aunt had benign nodules.) Thyroid cancer is very slow growing, and my cancerous thyroid nodules were diagnosed before they spread outside my thyroid, which meant I did not need radioactive iodine treatment. I had three nodules about 1-1.3 cm in diameter that were cancerous. My friend's nodule was over 2cm, and the cancer had spread outside of the thyroid, which meant a much more invasive surgery for him and radioactive iodine treatment (over 2cm doesn't automatically mean it has spread, it just becomes more likely the bigger it gets).
I know the idea of an FNA sounds scary. Thyroid cancer, especially if you are young, or if it is caught at an early stage, is incredibly treatable, and if it were me, I would opt for getting an FNA on the smaller nodule, just to make sure it is benign, rather than wait another year for another ultrasound. The procedure itself can be painful, but for me, the anxiety of not knowing whether my nodules were cancerous or not was more stressful than the pain from the FNA.
I hope this helps, and I'm sorry you have to deal with this too. My mom's thyroid nodules were found at a recent ENT appointment for something unrelated, and because of her family history, we were concerned. Thankfully, hers came back benign. I didn't want her to have to go through the FNA and possibly a thyroid cancer diagnosis like me, but I also wanted her to get tested to make sure that it wasn't anything she needed to worry about, and if it was something to worry about, we could make sure she got the treatment she needed.
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