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Q. What is the prognosis of hypertrophic Hashimoto's thyroiditis?

Answered by
Dr. Naresh Kumar Monigari
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 30, 2019

Hello doctor,

I have Hashimoto's thyroiditis and I felt like a lump in my lower throat. The doctor did a physical examination and noticed two nodules and sent me for an ultrasound. The result came back that the thyroid as a whole was hyperemic and heterotrophic in the background appearance.

The left lobe contained two nodules for which he then sent me to an ENT to do an FNB. Right now, usual symptoms of hypothyroidism are present like extreme fatigue, dry hair. But in the last couple of weeks, I have not been able to sleep on my back or side or put my chin down as it feels like the air is restricted.

My question is, what does this sound typical of thyroid cancer or a goiter? I am not an over reactor, I just wish I had more information or know the prognosis of cases that were similar to mine. Does this sound at a higher risk of cancer or more like a goiter? and if I am already on thyroid medication, what can they do to treat it?

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Hello,

Welcome to icliniq.com.

I had gone through all the data posted. From the details posted it appears as autoimmune hypothyroidism (Hashimotos). Kindly tell us the thyroid blood reports to know the control. Do you hear any sound while breathing (stridor) which indicates pressure on trachea? Breathlessness on lying back or on the side is unlikely due to thyroid unless it has retrosternal extension significantly which needs to be decided by clinical examination.

Do you get breathlessness while taking the stairs? Since how long do you have Hashimotos? Since how long you have noticed the increase in the size of swelling? Do you have a family history of thyroid cancer?

For definitive distinction of benign vs malignant FNAC (fine needle aspiration cytology) is important. If we have any doubt on FNAC we go ahead and do thyroidectomy and send thyroid tissue for histopathology examination which is the most confirmatory test.

Ultrasound is not so sensitive to differentiate benign vs malignant. So kindly wait for the FNAC report. Kindly get a complete physical examination in view of symptoms of shortness of breath before attributing those to thyroid problems.

Kindly review with further details so that I can help you better.


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