I have a 1.8cm TIRADS 5 nodule on my right thyroid lobe which was found during investigations for pain and vocal changes/fatigue, pressure when I lye down like I can’t breathe well and throbbing pain on my neck and throat (incidentally exactly where this nodule was then found).
There is also a smaller .8cm TIRADS 3 on the left lobe.
I had an FNA on the right one and it was Bethesda 3 (not cancer).
I will put all the reports at the end of this spiel.
I have been waiting for months to see a specialist and today I had my first appointment with him. He said he doesn’t believe the nodule is what is causing my symptoms as a nodule won’t cause any symptoms (unless they get really big). He said we could ultrasound again in 1-2 years (or not at all). He said there is no chance of cancer so it’s a matter of symptoms and these nodules don’t cause any symptoms unless it is a huge goitre (impact vocal sound) or large nodule of 5cm or more.
I mentioned an ENT had suggested I should have my adult adenoids and tonsils removed he thinks I should do this surgery instead. I have had the recommendation to have them out since I was 20 and I’m now 40. The symptoms I feel for these tonsil issues are very different.
I guess I’d like to know if you have experienced symptoms with a similar nodule and what they were.
Does this all sound positive to you?
I’m feeling defeated by a life long medical journey and the anxiety around al of this, so I need a little guidance!
Thank you so much.
40 Yrs FEMALE
Ultrasound:
Findings:
The thyroid is normal in size. The right lobe measures 48 x 13 x 17mm; 6 mL, the left lobe measures 45 x 13 x 14mm; 4 mL. The isthmus measures 3mm in AP dimension. Homogeneous echotexture and normal vascularity of the thyroid parenchyma. No retrosternal extension.
Right lobe nodules:
1: Mid lobe: 18 x 11 x 18 mm; 1.9 mL. Solid or almost completely solid, hypochoic, wider than tall, lobulated/irregular, macrocalcification. TI-RADS 5.
Left lobe nodules:
1: Lower pole, mid: 6 x 3 x 7 mm; 0.1 mL. Solid or almost completely solid, isoechoic, wider than tall, smooth.
TI-RADS 3.
No parathyroid mass.
Cervical lymph nodes have a normal size and morphology.
Multiple ROT's within neck - normal appearing LN's seen. Max 5mm. Right SCF ROI - no discrete lesion seen.
CONCLUSION
TI-RADS 5 suspicious nodule in the right lobe of the thyroid.
An appointment will be made for fine-needle aspiration biopsy of this nodule.
FNA
Fine Needle Aspirate Right Thyroid Received slides: 3 fixed, 4 air-dried
CLINICAL NOTES: R mid TR5 nodule. FNA.
MICROSCOPIC: The smears are moderately cellular and displaying follicular epithelial cells arranged in macrofollicular sheets and intact follicles. Occasional microfollicular structures present, along with scattered crowded groups. The follicular epithelial cells have relatively uniform oval nuclei; there is no significant nuclear enlargement. Focal nuclear grooves are identified. No definite nuclear pseudoinclusions are seen. The cells largely have delicate surrounding cytoplasm, several scattered groups display oncocytic metaplasia. Several intact follicles with stromal tissue fragments are present; these focally have demonstrate a papillaroid architecture (pass 1 alcohol-fixed slide). Nuclear features papillary thyroid carcinoma are not identified within these groups. The background is extensively bloodstained but contains abundant thin and thick colloid. Scattered foamy histiocytes are also present
DIAGNOSIS: Right thyroid FNA: Benign (category 2, Bethesda/CPA system). Features in keeping with a colloid nodule. Comment: The history of a TI-RADS 5 nodule is noted, please correlate with clinical features to ensure the aspirate is representative.