I was diagnosed to have a thyroid nodule and told to do an ultrasound after 6 months.?

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I did not do that due to insurance issues and cost. Also, I had not had any problems related to my thyroid that I noticed. Recently I notice a lump on the right side of my neck. Has anyone had the same symptoms? And, how urgent should I be about getting an ultrasound done?
You will be surprised to know the numerous things the thyroid controls, it's amazing. I had a nodule on mine, my heart was racing, I was sweating profusely, I lost weight, I couldn't concentrate well, my female times were very rough, my skin was dry, I felt like passing out a lot, etc. The symptoms go on and on. If you can, you should get the ultrasound done. All hospitals have social workers that will set up payment plans for you, if needed. Whatever doctor you see, tell them you need the most cost effective testing. There are so many things they can do. I started out with blood work. Then I had a Nuclear Medicine test where they had me take an iodine pill and lay under a camera that took pictures of the amount of iodine that goes to the thyroid, lets them see if the nodule is active or inactive. I never had an ultrasound at all. So if you tell them, cost effective, maybe they can work out a plan for you. I had surgery, removed 1/2 my thyroid and 10 years later had the rest killed with radioactive iodine (massive dose). With a nodule, it usually has to be surgically removed if it is interfering with thyroid activity. Get it checked. Good luck.  (+ info)

For people who had thyroid surgery to remove a nodule. How long were you incapacitated after the surgery?

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How long did it take you to get back to normal and get back to work after the surgery?
my husband was ready for work a few days later. Not really that big of deal.  (+ info)

I have a thyroid nodule and about one month ago I had a fine needle biopsy.?

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Recently I learned that I will require surgery because the doc's weren't able to tell if the nodule is malignant or not. Does anyone know anything about this type of surgery?
i had the same thing, first they do the needle biopsy and another biopsy one when they take out the nodule, the surgery is delicate cause there is a lot of blood vessels near, cost $ 22.000 dollars , the recovery is quick. the final biopsy determine malign or not but the neddle is a good indicator if go good. good luck  (+ info)

Does a thyroid nodule which has calcification inside usually turn out to be benign?

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53 year old women with hypothyroidism for 15 years.
You really can't tell by just that finding alone. I imagine you are talking about a thyroid sonogram showing a nodule with some calcification in it. 90% of solid nodules are benign, but calcification shouldn't be dismissed. It's best to get a fine needle biopsy and clarify the issue. A visit with an endocrinologist is a good idea. At age 53, you don't want to take any chances with this.  (+ info)

What is your experience with a Thyroid Nodule?

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I am 25 years old and my doc found a small 3X3mm nodlue on my thyroid 2 years ago. I just got another ultrasound and she found that it has grown to 5X7mm. I have to go see an endocrinologist and she thought that he might suggest i get a biopsy.

She wasnt too concerned that it was cancer, but since my thyroid labwork showed slight "hyperthyroid" activity she wants to figure this out.

I know nodules are common especially in young women. I have no history of cancer in my family. Although my labwork showed slight hyperthyroid, I am experiencing the EXCAT OPPOSITE maor symptom...i am gaining weight instead of losing.

to nodules contribute to hyper or hypo thyroidism? Do they remove small nodules like this or not usually? hmm.
Is removal of part or all of the thyroid a common procedure?
It has been said that if you had to have cancer, and if you had your choice, thyroid cancer should be high on your list because the cure rate is so excellent. Therefore, if you or your doctor discover a nodule (lump) in your thyroid gland don't panic. Thyroid nodules are very common, but only about 5% of them contain cancer, and more than 90% of thyroid cancers are curable.
To be sure to help yourself the most, follow your doctor's recommendations for the evaluation of your nodule to determine whether it is one of the 95% that are benign (harmless), or one of the 5% that are malignant.

Blood tests measure thyroid function
Here is what usually happens during an evaluation of a thyroid nodule: first you will have an examination and blood tests to determine whether the overall output of thyroid hormone is normal, increased, or decreased. Normal results are usually obtained, because thyroid nodules usually do not produce thyroid hormone, and also do not interfere with the function of the rest of the thyroid gland. Those few nodules that do actively produce thyroid hormone without regard to the body's needs are called autonomous nodules. Patients with these nodules may become hyperthyroid if the blood level of thyroid rises above normal. These nodules are nearly always harmless.

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On the other hand, sometimes nodules develop in thyroid glands that do not produce normal amounts of thyroid hormone, and blood levels of thyroid hormone in such patients may therefore be low. A very common condition in which this occurs is chronic thyroiditis. The disorder is also known as Hashimoto's thyroiditis in honour of the Japanese physician who first described it in 1912. In this condition, antibodies directed against the thyroid appear in the body, and often can be detected in the blood. Although a nodule in a patient with Hashimoto's thyroiditis is probably part of the thyroiditis, thyroid cancers are sometimes seen in these patients, so further study of such a nodule usually is necessary.

A very uncommon form of thyroid cancer, medullary cancer, produces a substance called calcitonin. Blood tests can detect calcitonin, sometimes even before these nodules can be felt. Since medullary thyroid cancer often runs in families, the calcitonin test can be done to make the diagnosis early when the disease is highly curable. However since this disorder is uncommon, serum calcitonin is checked routinely only when there is a family history of this type of thyroid cancer.

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Thyroid scan may help
An important and widely used initial screening test for thyroid nodules is the thyroid scan. If you have a thyroid scan, you will be given a tiny amount of radioactive material that is taken up by your thyroid. Imaging machines detect the radioactivity and record it on film to produce a picture showing the distribution of the radioactivity in your thyroid. Thyroid nodules may show up on scanning as zones of decreased activity ("cold" nodules) or zones of increased activity ("hot" nodules). Hot nodules almost never contain cancer.

Most cold nodules are also harmless, but since thyroid cancers usually appear as cold nodules as well, all cold nodules require further study. Some physicians advise an ultrasound test to determine whether a cold nodule is solid (as are most tumors whether or not they contain cancer) or a fluid-filled cyst. Ultrasound studies are being ordered less and less often, because needle biopsy will provide the same information, and also can provide cells and tiny tissue fragments for microscopic study by pathologists.

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Needle biopsy
Needle biopsy may sound frightening, but a local anesthetic is used, so that usually you will not have much pain, only a sensation of pressure or mild discomfort. Needle biopsies are of two basic types. If you are to have a fine needle biopsy, the physician doing it will use a very thin needle to withdraw thyroid cells. Ordinarily, several samples are taken from different parts of the nodule to ensure that the nodule has been studied thoroughly. Since large needle biopsy is done with a bigger needle that can take a core of tissue from the nodule, these larger tissue samples are easier for most pathologists to interpret. However, the fine needle biopsy which is simpler and produces less discomfort is the more commonly performed biopsy procedure.

It takes a few days to obtain the final report from the pathologist who examines the biopsy specimens. The report will usually indicate one of the following findings:

The nodule is benign (not cancer). This is the result obtained in approximately two-thirds of patients from whom enough tissue has been obtained in the biopsy test. Moreover this diagnosis by an experienced pathologist is highly reliable. The risk of overlooking a cancer is generally less than 5%, and less than 1% in medical centres with the most experience. Generally, these nodules need not be removed. Instead, your doctor may recommend treatment with thyroid hormone in an attempt to shrink the nodule, or at least prevent further growth. If the nodule fails to shrink, or enlarges during treatment, the biopsy can be repeated or the nodule removed surgically.
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The pathologist's diagnosis at surgery is almost always the same as that obtained from the needle biopsy. Even when enlargement of a nodule does occur, it is more likely to be caused by inner bleeding, degeneration, or inflammation than by malignancy.

The nodule is malignant (cancer). In my practice about 10% of nodules from which needle biopsy produces specimens adequate for diagnosis are malignant. Such nodules should be removed. Definite or highly suspicious findings of malignancy are nearly always confirmed at surgery. The extent of the operation performed depends upon the type of cancer, the extent of disease determined by tests before the operation, and also the findings during surgery.
The specimen is inadequate to make any diagnosis. Pathologists experienced with needle biopsy work tend to be very fussy about making diagnoses unless they are confident that sampling of the nodule has been adequate. Some thyroid nodules are composed of dense fibrous tissue, or have undergone such extensive degeneration that recognizable thyroid tissue cannot be obtained. In this situation it is usually best to repeat the biopsy. Other nodules are too small or too deep in the neck to permit needle biopsy. If an adequate specimen cannot be obtained, or if another needle biopsy is impractical, the decision to operate or just observe a thyroid nodule may be based on the physician's experience in evaluating nodules, the physical examination, and the test described above. In some cases your physician may decide to treat you with thyroid hormone for three to six months or longer in the hope that this treatment will cause the nodule to disappear, or at least to shrink as evidence that your nodule is harmless. If it does not get smaller, but instead enlarges, your physician is likely to recommend removal of the nodule in an operation.
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The biopsy specimen contains sizable amounts of thyroid cells or tissue, but the microscopic findings permit neither the diagnosis nor exclusion of thyroid cancer. About 18% of nodules for which needle biopsy produces specimens thought to be adequate for diagnosis have these inconclusive findings. The only way to establish a diagnosis on these nodules is to remove them surgically and carefully study them microscopically, looking for signs of malignancy. Still, most of these nodules (about 90%) are benign.
Diagnosis and management of thyroid nodules require skill and experience on the part of all physicians who participate in the evaluation. Needle biopsy has greatly improved the accuracy of diagnosis. In my clinic, the proportion of nodule patients for whom surgery is advised has been reduced significantly and, at the same time, a number of cancers that otherwise might have been overlooked have been identified and promptly treated.

Above all, if you think you have a lump in your thyroid, have it checked by your doctor. Most nodules are benign and cared for easily. But even those that do turn out to contain cancer are unlikely to develop into a life-threatening problem, since most thyroid cancers are curable. However, the earlier the treatment is given, the better the result will be for you.  (+ info)

If you have a single thyroid nodule with a small amount of vascularity at the periipherally of the nodule?

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with a small hypoechic component how much does this increase the chance of it being cancerous? I am scheduled to have FNA on the 30th.
Vascularity is not always a good indicator of a benign or cancerous nodule. Hypoechoic nodules are a little bit more suspicious. Your FNA biopsy will let you know for sure. Good luck!  (+ info)

is a round well circumscribed nodule on the thyroid more likely to be cancerous than one that has unclear and?

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jagged edges? It the nodule is primarily isoechoic does this increase risk it also has a small hypoechic component. Nothing I have read mentions isoechoic, so far everything I have read mentions hypoechoic and hyperechoic in the description of nodules . If it is isoechoic does this mean it doesnt have a halo or hilum around it?
A round well circumscribed nodule are characteristics of a benign nodule, You are trying to read more into the report than what is there. The doctor states what it is right in the report. Also the doctor who ordered the test should have gone over the findings with you so you should not have any questions about it now.  (+ info)

What is asperation and sonogram for thyroid nodule/?

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If mass is found on MRI, what is a sonogram/asperation, etc.?
A thyroid fine needle aspiration should be obtained on palpable thyroid nodules and on thyroid nodules larger than 1 cm that are detected by other means (eg, sonogram). There are occasional exceptions to this guideline, such as when a patient has a disabling condition (eg, known metastatic cancer from another site).

This particular case is especially noteworthy because the patient's nodules are bilateral and located at the upper third of each lobe, raising the suspicion of medullary thyroid cancer. C cells tend to concentrate in these areas of the thyroid gland. The family history suggests at least the possibility of a pheochromocytoma (possibly multiple endocrine neoplasia type 2A [MEN 2A]), with one family member dying suddenly. Pheochromocytomas can become manifest during times of stress, such as surgery.

The fine needle aspiration is the cornerstone of the diagnosis of a thyroid nodule(s).[1-3] However, clinical history and physical examination must also be considered. A clinical history of head and neck irradiation, a family history of thyroid cancer (eg, medullary thyroid cancer), dysphonia, rapid growth, or associated neck masses (eg, cervical adenopathy) all increase the likelihood of the nodule being malignant. Nodules that are very firm on examination and are fixed to the surrounding tissue also are more likely to be malignant.[4] Patients being examined for a thyroid nodule should have routine laboratory tests, including CBC, comprehensive medical profile, free T4, TT3, and TSH. Thyroid antibodies may also be helpful. Serum calcitonin levels are not yet measured routinely by most clinicians, but should be obtained if there is a family or personal history suggestive of MEN2 or medullary thyroid cancer, or if an aspiration suggests medullary thyroid cancer.

Many different pathologic processes may present as a "thyroid nodule," and this observation increases the importance of performing a fine needle aspiration, even if the patient is scheduled for surgery on the basis of clinical grounds. Thyroid nodules may represent benign thyroid adenomas, cysts, thyroiditis, infections, infiltrative diseases, or a thyroglossal duct cyst. Most thyroid nodules do represent a benign process. However, about 10% to 20% of nodules are malignant. Possible thyroid malignancies include papillary thyroid cancer, follicular thyroid cancer, medullary cancer, or anaplastic cancer. Lymphoma of the thyroid gland can occur as the only manifestation of this disease or could represent one of multiple sites of disease.

It is important to know prior to surgery what possibilities in the differential diagnosis deserve more serious consideration. For example, a patient with a thyroid lymphoma may not require thyroid surgery, and additional staging studies will have to be performed. Primary nonthyroid cancer, such as renal, breast, melanoma, colon cancer, and leukemia, may involve the thyroid gland. This involvement may represent one of many sites of metastatic disease or could involve the thyroid gland as the initial site of detectable disease or recurrence. Again, it is important to have this relevant information, because the fine needle aspiration would likely affect the diagnostic evaluation and therapeutic plan contemplated. On rare occasions, a parathyroid cyst or adenoma, thymic tissue, or lipoma may present as a thyroid nodule. A fine needle aspiration is safe and relatively inexpensive yet can aid tremendously in the diagnosis of thyroid nodules.

If the fine needle aspiration of a thyroid nodule is benign, and assuming there are no worrisome clinical or laboratory findings, most patients will be followed with periodic sonograms, laboratory studies, and physical examinations -- perhaps every 6 months for several years. If the nodule is growing, then repeat fine needle aspiration should be performed, with consideration of surgery. We tend to recommend at least 1 repeat fine needle aspiration for all patients who are being followed with thyroid nodules. The false-negative rate for a single aspiration is about 2% to 5%, and a repeat fine needle aspiration about 6-12 months after the initial aspiration will decrease the chance of not detecting a thyroid cancer. This recommendation for a repeat aspiration is controversial. However, there is no debate concerning the importance of following patients who have a benign fine needle aspiration with periodic neck examinations and periodic sonograms. Moreover, clinical findings are also extremely important. If a thyroid nodule is larger than about 3-4 cm or if the patient has associated local symptoms as noted above, surgery should be strongly considered even if the aspiration is interpreted as benign. The false-negative rate of thyroid fine needle aspirations of nodules larger than 2-3 cm is higher than the 2% to 5% figure quoted above.

Fine needle aspirations must be interpreted by experienced thyroid cytologists, and surgery must be performed by accomplished thyroid surgeons. The optimal approach, of course, is through an integrated multidisciplinary team that presents the same views and philosophies to the patient and family. The patient is considered an integral part of this team.

If the fine needle aspiration is suspicious for thyroid cancer or is diagnostic of thyroid cancer, surgery is indicated. A fine needle aspiration that shows thyroid cancer has about a 99% chance of actually being malignant on final pathology, with the false-negative rate being less than 1%. A suspicious fine needle aspiration could be suspicious for papillary cancer or could show follicular neoplasm. Probably, the former has about a 30% to 50% chance of actually being malignant and the latter about a 10% to 20% chance of being malignant. Nonetheless, it is important to diagnose and appropriately approach patients with these suspicious interpretations. If the aspiration slides are interpreted as malignant, then a thyroidectomy is recommended. Whether to recommend a near total thyroidectomy or lobectomy (with isthmusectomy) is a difficult decision. The clinical context and patient desires are important in this decision. A thyroid sonogram (or appropriate other radiologic study such as MRI) should be performed to help determine whether there are lesions on the contralateral side, in which case a near total thyroidectomy would usually be recommended. Of course, assessment of the size and characteristics of the contralateral lesion(s) is important, and an aspiration of the contralateral lesion may also be helpful.

In general, if the patient has suspicious thyroid aspiration, a lobectomy is recommended, and if the patient has thyroid cancer on final pathology then a completion thyroidectomy is performed, usually within 1-3 weeks. However, as noted, at least 50% of patients with a suspicious thyroid aspiration will turn out to have benign lesions on final histology. If a near total thyroidectomy is recommended as the initial surgery, more than half of the patients would theoretically not have required this operation because their histology would be benign. However, a significant percentage of patients with suspicious cytology would require a completion thyroidectomy if they had elected to have a lobectomy as their initial procedure.

Surgery must be performed by an experienced thyroid surgeon, but even then the complication rate is about 1% to 5% for permanent hypoparathyroidism, 5% to 10% for permanent hypoparathyroidism, and probably less than 1% for permanent hoarseness due to injury to the recurrent laryngeal nerve. These estimates vary widely in the literature. Transient hoarseness is slightly more common and can result from nerve paresis as well as mild injury to the vocal cords during intubation. Over time, permanent hypothyroidism following a lobectomy is relatively common and is probably at least 30% to 50% over 5-10 years. Earlier studies suggesting the rate of hypothyroidism was lower did not include measurements of TSH, and it is now known that an elevated TSH bespeaks hypothyroidism even if the serum free T4 and TT3 are within the normal range. Most thyroidologists believe that this condition, subclinical primary hypothyroidism, should be treated, especially if the TSH is greater than 10 mcU/mL. Patients who have had a near total thyroidectomy and still have normal thyroid function tests and TSH should still be followed for life for the development of hypothyroidism.

Thyroid cancer treatment is beyond the scope of these comments, and readers are referred to relevant articles on the topic.[5,6] However, most thyroidologists recommend a near total thyroidectomy for patients with thyroid cancer. I believe that a near total thyroidectomy and subsequent radioactive iodine therapy should be performed for all patients with follicular thyroid cancer and all patients with papillary thyroid cancer larger than about 5-10 mm. The size criteria given of about 5-10 mm is controversial and depends on the clinical context and the patient's desires. There are multiple clinical scenarios that arise, and each patient is considered individually. For example, on one extreme, if a patient has a lobectomy and a 2-mm papillary thyroid cancer is discovered incidentally and the remaining lobe is normal on sonogram, subsequent radioactive iodine would not be recommended routinely. This patient should undergo periodic examinations for residual disease with the frequency decreasing over time. On the other extreme, if a patient had a lobectomy and a 2-cm papillary thyroid cancer was discovered, then a completion thyroidectomy with subsequent radioactive therapy would be recommended.

Radioactive iodine has been found to decrease the rate of recurrence and mortality of patients with differentiated thyroid cancer (ie, papillary and follicular cancer).

Medullary thyroid cancer is a complex disease. It is detected preoperatively on fine needle aspiration probably about 50% of the time, and measuring serum calcitonin concentrations will help in the proper context. Mild elevations of serum calcitonin may represent spurious changes. Medullary thyroid cancer occurs sporadically about 70% of the time, and the remaining time may be part of a familial syndrome. The familial syndrome could be MEN2 (medullary thyroid cancer, pheochromocytoma, hyperparathyroidism), MEN2B (medullary thyroid cancer, hyperparathyroidism, associated disorders such as ganglioma), or familial medullary thyroid cancer. Measurement of the Ret oncogene to detect familial disease is extremely important. Please refer to previous column on this topic for additional information.

To return to the patient presented at the beginning of this discussion, the possibility of medullary thyroid cancer is raised because of the family history of a relative dying of an unexpected surgically related event (possibly pheochromocytoma). The thyroid sonogram showing bilateral thyroid nodules specifically at the junction of the upper two thirds and lower third of the thyroid is characteristic, but not diagnostic, of medullary thyroid cancer. A fine needle aspiration of each nodule should be performed. Preoperative screening for hyperparathyroidism and pheochromocytoma must be performed.  (+ info)

Can a small thyroid nodule cause symptoms?

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Doctor's have sent me blood work 3 times end it is always normal, but i had an ultrasound done and i have a small nodule on left side of my thyroid my thyroids lookes abnormal. and have symptoms like tremors in my hands i feel jittery, anxious, palpitations, hair falling out,trouble swallowing, have mood swings, i feel sleepy all day, muscles fell weak, low body temperature, could this be the nodule i have or is it just anxiety?
Make sure you get tested for celiac disease. I basically had all of those and my labs came back mildly hypothyroid, but it didn't explain all the symptoms including the anxiety and shakiness. I found out later that I had celiac disease which causes thyroid problems. All of those symptoms are associated with celiac disease. It's an autoimmune disease caused by gluten intolerance so the cure is a gluten free diet. Let me know if you have any questions. I accept pm's.

http://thyroid.about.com/cs/latestresearch/a/celiac.htm
http://www.csaceliacs.org/celiac_symptoms.php
http://www.celiac.com/articles/1106/1/Celiac-Disease-Symptoms/Page1.html
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

oh, and also, there is such a thing as subclinical hypothyroidism. It's where you have all the symptoms, but your labs are normal. Many doctors recognize it now. Also, get your labs and look at them to make sure they aren't using an outdated scale. That's what happened to me. My TSH was like 4.5 and the doctor told me it was normal. It wasn't.  (+ info)

My dr. told me I had a nodule on my thyroid and I have to get a biopsy but now iam pregnant is it safe?

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I have hyperthyroid and Iam pregnant is it safe to get a biopsy?
It should be fine but if you want to be certain, contact your doctor and ask. I had a biopsy done and all they do is lay you down, numb the thyroid with some stuff that is injected with a needle. Then they take a needle that is a bit bigger and stick it in and move it in and out (like mini liposuction, almost). They do that a couple of times with different needles in different areas to get a few samples. It wasn't bad at all.  (+ info)

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