Is a morphological change in a 12mm thyroid nodule serious?

Question

Hello doctor,

My wife got her thyroid scanned by a novice user just for training purposes. She has been scanned in the hospital before, as part of an assessment of an autoinflammatory disease. At this time, they found a thyroid nodule (approximately 12 mm), but no further investigation was conducted, as it seemed benign.

Now, at the training scan, we observed that the nodule had changed in shape and size, and it looks like there are some microcalcifications. But we are not the experts. We noticed it has changed. Could you give your second opinion on the attached images?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

According to the American College of Radiology thyroid imaging reporting and data systems (TIRADS), the nodule falls under category TR4, which defines it as moderately suspicious. However, as you mentioned, there is a change in morphology with the development of microcalcifications.

Microcalcifications are a feature of papillary carcinoma of the thyroid, and therefore, it is essential to rule out that for which a fine needle aspiration cytology and biopsy (FNAC-FNAB) is recommended.

Therefore, the differential diagnosis in your case will be papillary carcinoma of the thyroid and a benign colloid nodule.

Further, I would like to know if any necrotic neck nodes were detected. Let me know the results. I assume that the nodule turns out to be benign and not malignant.

I hope this answers your query.

Thank you.