Just Beginning

I am experiencing an overwhelmingly frustrating situation in trying to get any information.  I have not spoken to my doctor that started me down this road (she is a GYN/OB) only her nurse, and they just keep moving me on this path.  I did finally obtain the 'report' from the scan and ultrasound.  Of course the report has a lot of terminology that I'm having trouble defining, but bottom line it seems that I have numerous 'cold' nodules, and the Ultrasound folks recommend a fine needle aspiration.  And am now being shuffled off to an endocrinologist, that can't see me for several weeks.  Can any one help me with these terms?  "inhomogeneous parenchyma"  "Hypoechoic nodule" Nodule does not demonstrate "through-transmission" and is not "define cystic" (sic)  "Heterogeneous nodule"  "Adenopathy"  "Circumscribed complex nodule"

Thanks for your help!

May I ask how your OB/GYN found thyroid nodules?  Did you forget to wear your "THIS END UP" arrow for your annual PAP?  Just kidding.  However it was found, be grateful to know there is something wrong so it can be taken care of as soon as possible.

From my own very recent and very limited experience (so far), I can tell you I had the same frustration getting in to see an endocrinologist within a reasonable amount of time.  The best way to get in earlier is not to make the appointment yourself, but demand your primary physician or the OB/GYN refer you to them directly.  They will need to call the endocrinologist and tell them you need to be seen quickly.  If that doesn't work, then maybe you need to search for other doctors in a different area if you can.  Don't be afraid to consult a cancer specialist if you have any fears your nodules are malignant.  I cannot imagine any doctor that would tell you there are nodules in your thyroid and not hurry you through to an endocrinologist.  You deserve better care than that.

My nodules were discovered by accident through a carotid artery ultrasound, so I know the shock that comes in finding something you weren't looking for.  Like you, my nodules were "hypoechoic;" I believe that means they are solid, not fluid-filled.  Please visit the Thyroid Cancer website at http://www.thyca.org for information about the various kinds of nodules, etc.

Also, you can Google the medical terms you don't understand to learn there definitions.

Take care.

Inhomogenous parenchyma means that the tissue being evaluated is not all one color (echogenicity); there are bright spots and dark spots.  This usually means there is something wrong with the tissue but is not specific as to whether what is wrong is benign or malignant.  A hypoechoic nodule means that the nodule is darker in color than the surrounding tissue.  Through-transmission happens when the sound from the ultrasound probe goes through fluid, it causes deeper tissues to look bright.  So if you go through a cyst, on the other side of the cyst the tissue looks bright.  If it did not demonstrate through-transmission, it probably isn't a cyst.  Heterogeneous nodule means the nodule is inhomogenous.  Circumscribed complex nodule means that the nodule has well-defined borders, but the nodule is made up of many different looking tissues (similar to inhomogenous/heterogeneous).  Adenopathy strictly means "pathology of a gland"...pretty vague.  I don't know what each of the objects described are...and the sonographer probably doesn't either, I only know what the terms mean.  I know it is hard to wait for results.  Good luck.

Wonderful definitions!  Thank you so much!  I'm grateful for this information.  From what I've been reading, these nodules sound 'solid', so I'm assuming the next step is FNA (fine needle aspiration)/biopsy.  Correct?  Unfortunately, when I called the endocrinologist office to encourage that be done now, so she could have the results when I visit, it sounds like she wants to visit first.  I would think if she has read the reports and looked at the images that, other than getting answers from me about my history, she would recommend FNA as the next step.  I guess I'm impatient- just want to be moving forward, have definitive answers and know what I'm dealing with.  I can deal with whatever it is, just need to know!

How do you know so much?  Have you been through this?  If so, hope all is well.

Thanks again, 'knowing' is comforting to me, and you've helped!

Thank you so much.  Love your sense of humor too!  Website is very helpful.  Thanks for taking the time to respond.  This is a wonderful site, and I'm so lucky to have stumbled on it.

I know the definitions because I'm a veterinary radiologist and part of my job is doing ultrasound.  I can't tell you much about interpretation of things a person may see in a human thyroid, but I have to know the lingo....

I imagine the next step is FNA.  I've had it done and it isn't too bad.  My diagnostic work-up was pretty quick because I got the ball rolling.  I noticed lumps in my neck and took a look with ultrasound when I came to work.  Then I saw all these huge lymph nodes and a clearly abnormal thyroid gland.  Scared the heck out of me because in dogs thyroid cancer warrants a pretty bad prognosis.  I called my internist and she saw me in two days and sent me downstairs for a CT and ultrasound.,  Her next-door neighbor is an endocrinologist and I saw her the next day...then I had the FNA done a couple days later.  Then, with the diagnosis of papillary carcinoma with spread to many lymph nodes, I waited a very long month before my thyroidecomy and neck dissection.  My endo wanted to make sure I got the "good surgeon" and kept explaining that this tumor type is very slow growing and I've probably had it for years, etc., etc.  It was still very stressful. Hang in there.