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Thyroid Nodules - can anyone explain this lab report for me, please?

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Thyroid Nodules - can anyone explain this lab report for me, please?

Postby alberic44 » Sat Aug 20, 2011 6:33 pm

This is what the thyroid study says:

report starts------->
Clinical Information: Thyroid Nodules
24 hour RAIU 11.4% (Normal 8-32%)

Thyroid scan done with Technetium. There is an area of lack of uptake in the middle to lower part of the left thyroid lobe laterally and in the middle of the right thyroid lobe laterally.

Interpretation: Abnormal study. Areas of lack of uptake to both thyroid lobes.

This study was compared with thyroid ultrasound which described non-homogeneous texture with multinodular pattern, the largest nodules are 1.9 x 1.3 cm in the upper pole on the right thyroid lobe and 1.8 x 1.3 in the mid pole of the left thyroid lobe and 1.6 x 0.6 cm in the isthmus. The nodule in the left thyroid lobe corresponds to the area of the lack of uptake on the thyroid scan. In the right thyroid lobe, the cold area is within the upper and mid part, so the nodule also corresponds to the area of lack of uptake on the thyroid scan. Isthmus nodule not seen on the thyroid scan.
<------report ends

The report does go on to recommend a thyroid biopsy which is already scheduled but neither my doctor nor I understood the lab report (see above) from the nuclear testing on the thyroid. Any help would be most appreciated. Further, what are the chances that this is thyroid cancer? And what is the appropriate treatment for this thyroid condition (patient is also on synthroid for under-functioning thyroid)?
alberic44
 
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Thyroid Nodules - can anyone explain this lab report for me, please?

Postby earie » Sat Aug 20, 2011 6:35 pm

Cold nodules (non functioning - the nodule is not taking up radioactive iodine normally) do not produce excessive amounts of thyroid hormone. With cold nodules, thyroid cancer is more likely if there are symptoms of pain in the neck, difficulty breathing or swallowing, a change in voice and swollen lymph glands in the neck. Approximately 5% of all nodules are cancerous with a survival rate over 90%. The most sensitive test for a benign or malignant thyroid is a fine needle aspiration biopsy.

Risk factors for developing nodules include a lack of iodine in the diet, which can cause thyroid enlargement, family history of benign thyroid nodules, and pre existing thyroid disease (e.g. Hashimoto's thyroiditis - most common cause of hypothyroidism). About 1/3 to 1/2 of all thyroid nodules shrink spontaneously without medication. Thyroid hormone medication is shown to shrink some thyroid nodules. If deficient in iodine, then supplementing with iodine may help shrink thyroid nodules. In other cases, increased exercise and acupuncture have helped with thyroid nodules, but results have not been proven for all patients.

Thyroid disease >>>
http://www.sensible-alternative.com.au/metabolic-hormones/thyroid-article

Selenium for Hashimoto's Thyroiditis >>>
http://jeffreydach.com/2009/11/07/selenium-for-hashimotos-thyroiditis-by-jeffrey-dach-md.aspx

Thyroid nodules >>>
http://cpmcnet.columbia.edu/dept/thyroid/nodules.html
earie
 
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Thyroid Nodules - can anyone explain this lab report for me, please?

Postby aldo » Sat Aug 20, 2011 6:43 pm

The "non-homogeneous texture" essentially means that the surface is irregular where it should be smooth. I am pretty sure that the reference to a "cold spot" refers to an area where the tracer substance - technetium, which should have been taken in by any active part of your thyroid, was not actually taken up. The technetium is very mildly radioactive, and thus referred to as "hot." It will show up in a diagnostic scan, and the places it shows up are called, casually by physicians, "hot spots."

The technetium used to test your thyroid function should have been present in areas of your thyroid that are functioning normally. Any place the technetium did not get taken up - a "cold" spot, would be suspected of not functioning normally. It is NOT entirely conclusive that an area that did not take up technetium is pathologically malfunctioning. That's why a biopsy was recommended. Unfortunately, only the biopsy will reveal more conclusive data. You will have to wait for those results.

Overall, the report says that your thyroid appears not to be normal on visual inspection by imaging. It also says that the parts that look abnormal also do not take up technetium in a way that would be expected of healthy thyroid tissue. That means that parts of your thyroid neither look normal nor appear on a preliminary test to be functioning normally. The technetium study and a visual assessment both showed unusual conditions in the same areas of parts of your thyroid. That visual images and the technetium study were consistent or in agreement still is not entirely conclusive. The biopsy is needed.

You should keep in mind that even if the visual images and technetium diagnostic study are correct, and that parts of your thyroid are not healthy, that does NOT mean you have thyroid cancer. Again, this requires the biopsy of the relevant tissue. It is possible that part of your thyroid is malfunctioning, and that those parts might not recover normal function, BUT that your thyroid still is not affected by a malignancy of any sort. I emphasize this because I trust that you are afraid you have a cancerous condition in your thyroid. You might, but only the biopsy can reveal that, and at this time there is NOT sufficient evidence to diagnose cancer OR to rule out cancer.

I will remember you and your doctors in my prayers.

Peace be with you my friend.
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