Dr. Thiyagarajan. T
Diabetology
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Patient's Query
Hello doctor,
I had an MRI (magnetic resonance imaging) done, and they found a 6 mm nodule on my thyroid. They decided to get a baseline ultrasound, and the results are as follows:
The right lobe measures 45 x 21 x 15 mm. The left lobe measures 46 x 18 x 14 mm.
Right lobe:
The right lobe has homogeneous echotexture. There is a 1.4 x 0.9 x 0.6 cm isoechoic solid nodule. There are no calcifications.
Left lobe:
The left lobe of the thyroid has a homogeneous echotexture. There are no significant nodules in the left lobe of the thyroid. The thyroid isthmus is unremarkable.
Impression: Right thyroid nodule, 12-month follow-up, thyroid ultrasound recommended.
My guess is they gave it a score of 3. My question is, would it require a biopsy if it had been 1.5 cm instead of 1.4 cm? What are your thoughts on follow-up?
Thank you.
Hello,
Thank you for stopping by!
I am here to provide expert opinions on your medical issues.
You have what we call a low-risk thyroid nodule - (ATA risk classification 2015) or TIRADS (Thyroid Imaging Reporting and Data System) 3, as you have mentioned. The risk of malignancy is 5 to 10 %, and the guidelines recommend a biopsy with a size greater than 1.5 cm. But we have to consider individual risk factors such as a family history of thyroid cancers, a history of radiation exposure, and other characteristics the radiologist may not have reported, such as proximity to the thyroid capsule or trachea, wider than tall or taller than wide, etc. So if you have images of the nodule, it would help me to look at it and refine my recommendation. If this makes you lose sleep, get a biopsy done at the end of the day. Or wait for 6 to 12 months and repeat the ultrasound, and if the size has increased or characteristics changed by then, get a biopsy done.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
One more question. I had a chest CT (computed tomography) scan two years back. It showed no abnormal finding in the lower neck. Can thyroid nodules hide on CT? Meaning is this a new growth, or are ultrasounds more sensitive at detection? I can email you the ultrasound.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
CT (computed tomography) scans will pick up thyroid nodules. Either the uppercuts of the CT chest were not high enough to include the thyroid area, or the nodules are new growth or were not noticed then. It is fine if you cannot attach the images. My recommendation is to repeat the ultrasound in six months.
Hope this helps.
Thank you.
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Diabetology
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