Solid nodule

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Solid nodule

by dinazulu on Tue Dec 20, 2016 11:36 PM

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Last January my primary care physician discovered on exam that I had a goiter. After ultrasounds and a FNA I was referred to an endocrinologist who has been monitoring me ever since. My most recent ultrasound (last Monday) showed that some of the nodules are no longer cystic and are now solid...well one in particular. Now I am scheduled for another FNA to determine pathology of solid nodule. I had Hodgkin's disease 18 years ago with radiation to my neck. any chance that this isn't cancer?

RE: Solid nodule

by butterfly501 on Wed Dec 21, 2016 06:38 PM

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On Dec 20, 2016 11:36 PM dinazulu wrote:

Last January my primary care physician discovered on exam that I had a goiter. After ultrasounds and a FNA I was referred to an endocrinologist who has been monitoring me ever since. My most recent ultrasound (last Monday) showed that some of the nodules are no longer cystic and are now solid...well one in particular. Now I am scheduled for another FNA to determine pathology of solid nodule. I had Hodgkin's disease 18 years ago with radiation to my neck. any chance that this isn't cancer?

Did doctor's indicate that the radiation treatment would increase your chances for thyroid cancer?

In general, more than 90% of thyroid nodules are benign.

RE: Solid nodule

by dinazulu on Tue Jan 03, 2017 03:34 PM

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Yes. Radiation exposure to the chest and neck area as a child increases the risk of thyroid cancer.  I am just concerned that the nodule changed appearance.  It went from being cystic to solid.  I know that solid nodules are more consistent with cancer.  My biopsy is not scheduled until February 3rd.  I am just a little nervous.

RE: Solid nodule

by butterfly501 on Tue Jan 03, 2017 09:28 PM

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Page 14, table 6 of the professional guidelines at thyroid.org may be useful for you; if you have the detailed ultrasound report.

RE: Solid nodule

by butterfly501 on Tue Jan 03, 2017 09:35 PM

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Table
6.
Sonographic Patterns, Estimated Risk of Malignancy, and Fine-Needle Aspiration
Guidance for Thyroid Nodules
Sonographic pattern
US features
Estimated risk
of malignancy, %
FNA size cutoff
(largest dimension)
High suspicion
Solid hypoechoic nodule or solid hypoechoic
component of a partially cystic nodule
with
one or more of the following features:
irregular margins (infiltrative, microlobu-
lated), microcalcifications, taller than wide
shape, rim calcifications with small extru-
sive soft tissue component, evidence
of ETE
>
70–90
a
Recommend FNA at
1cm
Intermediate suspicion
Hypoechoic solid nodule with smooth mar-
gins
without
microcalcifications, ETE,
or taller than wide shape
10–20
Recommend FNA at
1cm
Low suspicion
Isoechoic or hyperechoic solid nodule, or
partially cystic nodule with eccentric solid
areas,
without
microcalcification, irregular
margin or ETE, or taller than wide shape.
5–10
Recommend FNA at
1.5 cm
Very low suspicion
Spongiform or partially cystic nodules
with-
out
any of the sonographic features de-
scribed in low, intermediate, or high
suspicion patterns
<
3
Consider FNA at
2cm
Observation without FNA
is also a reasonable option
Benign
Purely cystic nodules (no solid component)
<
1
No biopsy

RE: Solid nodule

by Cedar_tree on Thu Feb 09, 2017 03:29 AM

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I am in the same boat as you  hodgkins 16 years ago.  My thyroid fna came back follicular neoplasti.  Ent wants to monitor for another six months and then redo fna....I have been dealing with the choking sensation since Aug,  hoarsness and loss of voice since October and Next and ear pain.  I said what are they going to do about the symptoms and she said the hoarsness is because I don't drink enough water.  I wanted to slap her.  Anyway... it was then suggested because of my history (hodgkins & 2 family members with thyroid cancer) that the could do a right hemiectomy...but there is no rush.  I am very unimpressed so far.  Cancer or no cancer I am not going to sit here and wait like I had to before they caught the hodgkins.  I just want it out.  Then at least I will have less stress and some piece of mind.

RE: Solid nodule

by dinazulu on Thu Feb 09, 2017 04:23 AM

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I switched to a second endocrine doctor. A very well respected endocrine surgeon actually... she told me that my goiter is so large that it is pushing my trachea to the right of my neck...which is creating some problems for me. She could not believe my prior doc didn't happen to mention that. She also told me these FNA biopsies are bs. They almost always come back inconclusive. So March 6th I am scheduled for surgery... Good luck to you as well! Don't forget that second opinions are a wonderful thing!

RE: Solid nodule

by Cedar_tree on Thu Feb 09, 2017 10:58 PM

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Thanks.  I often find that getting a referral for a second option is almost as difficult as the waiting... it took me 4 months to get in to see the first endo doc...and she is suppose to be the best there is in the area!

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