Thyroid Nodules - Can I Request a Biopsy?

Posted by antron @valtron, Jan 26, 2023

Hello all - long time lurker here wanting to get some clarification on thyroid nodule biopsies. An ultrasound revelead that I have 2 solid, hypoechoic nodules on my thyroid, along with it being diffusely heterogeneous and hypervascular. Most of my thyroid labs came back normal except my TPO levels which came back at >1,000 IU/mL.

I already have an appt with an endocrinologist mid Feb, but I want to prepare for the appt. All signs seem to be pointing to Hashimoto's, but I am wondering if I can still request a biopsy of the thyroid nodules to rule out cancer.

Any input would be greatly appreciated! Something's been off with my body for just over a year now and after nerve studies, mri's, etc. this is the closest I've gotten to any answers as to what's causing my issues.

Thank you all!

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Hi,
I just had a sonogram of the thyroid. It shows 5 nodules that are small. All under 1 cm. Heterogeneous in echo texture and subjective normal vascularity bilaterally. No suspicious modularity seen. That last sentence relaxed me some, but the nodules are none the less in the thyroid

It is recommended I have another ultrasound in a year.

I have to wait until I see my endocrinologist to ask her questions.

Like what condition makes a person develop nodules in the first place.

Did the radiologist make a recommendation?

I hope you find answers. What makes you think Hashimotos?

Take Care.

REPLY
@nemo1

Hi,
I just had a sonogram of the thyroid. It shows 5 nodules that are small. All under 1 cm. Heterogeneous in echo texture and subjective normal vascularity bilaterally. No suspicious modularity seen. That last sentence relaxed me some, but the nodules are none the less in the thyroid

It is recommended I have another ultrasound in a year.

I have to wait until I see my endocrinologist to ask her questions.

Like what condition makes a person develop nodules in the first place.

Did the radiologist make a recommendation?

I hope you find answers. What makes you think Hashimotos?

Take Care.

Jump to this post

& @valtron Good morning - I think your endocrinologists' will have useful answers for you. Here is what Mayo Clinic has to say about thyroid nodules:
https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/diagnosis-treatment/drc-20355266
My nodules have been watched annually for over 20 years. They were first observed on ultrasound (one was very large & you could palpate it - which led to the test in the first place.) I was very nervous about it, and consented to an ultrasound guided biopsy - but by the time it happened, the largest nodule had shrink & solidified, so no fluid could be drawn. The smaller ones were too small for the needle to penetrate without also penetrating surrounding blood vessels. Let me say it was a thoroughly miserable experience, leaving me with a very sore & bruised neck and no answers.
Fast forward 10 years, I was diagnosed with Graves disease (hyperthyroid) brought on by another condition. The nodules were still present & slightly changed, so another biopsy was done. Still a miserable procedure, but at least we got answers - no cancer.
And another 10 years - we will be doing another ultrasound in May - my fingers tell me the original nodule is slightly larger, but I am still confident that "watch and wait" is the right answer for me.
Sue

REPLY
@nemo1

Hi,
I just had a sonogram of the thyroid. It shows 5 nodules that are small. All under 1 cm. Heterogeneous in echo texture and subjective normal vascularity bilaterally. No suspicious modularity seen. That last sentence relaxed me some, but the nodules are none the less in the thyroid

It is recommended I have another ultrasound in a year.

I have to wait until I see my endocrinologist to ask her questions.

Like what condition makes a person develop nodules in the first place.

Did the radiologist make a recommendation?

I hope you find answers. What makes you think Hashimotos?

Take Care.

Jump to this post

Thank you for your response, I truly appreciate you sharing your experience with thyroid nodules.

They recommended another ultrasound in a year to check on the size, but nothing about a biopsy. I might just ask the endocrinologist if they can order one so I can have some piece of mind.

I'm thinking Hashimotos based on my symptoms, family history, and my latest thryoid test results. Of course I will wait until I can speak to a doctor about this, but I always like to gather as much info as possible going into these conversations!

REPLY
@sueinmn

& @valtron Good morning - I think your endocrinologists' will have useful answers for you. Here is what Mayo Clinic has to say about thyroid nodules:
https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/diagnosis-treatment/drc-20355266
My nodules have been watched annually for over 20 years. They were first observed on ultrasound (one was very large & you could palpate it - which led to the test in the first place.) I was very nervous about it, and consented to an ultrasound guided biopsy - but by the time it happened, the largest nodule had shrink & solidified, so no fluid could be drawn. The smaller ones were too small for the needle to penetrate without also penetrating surrounding blood vessels. Let me say it was a thoroughly miserable experience, leaving me with a very sore & bruised neck and no answers.
Fast forward 10 years, I was diagnosed with Graves disease (hyperthyroid) brought on by another condition. The nodules were still present & slightly changed, so another biopsy was done. Still a miserable procedure, but at least we got answers - no cancer.
And another 10 years - we will be doing another ultrasound in May - my fingers tell me the original nodule is slightly larger, but I am still confident that "watch and wait" is the right answer for me.
Sue

Jump to this post

Thank you for sharing the link, there was so much good information there. I appreciate you taking time to share more about your journey, too. Ooof, that biposy experience does sound miserable. I feel like mine are pretty large (like my pcp could tell just by looking at my neck that something was going on), so fingers crossed I am a good candidate for the biopsy and that I get answers too.

thanks again!

REPLY
@valtron

Thank you for your response, I truly appreciate you sharing your experience with thyroid nodules.

They recommended another ultrasound in a year to check on the size, but nothing about a biopsy. I might just ask the endocrinologist if they can order one so I can have some piece of mind.

I'm thinking Hashimotos based on my symptoms, family history, and my latest thryoid test results. Of course I will wait until I can speak to a doctor about this, but I always like to gather as much info as possible going into these conversations!

Jump to this post

Best of luck and good health to you.

REPLY
@valtron

Thank you for sharing the link, there was so much good information there. I appreciate you taking time to share more about your journey, too. Ooof, that biposy experience does sound miserable. I feel like mine are pretty large (like my pcp could tell just by looking at my neck that something was going on), so fingers crossed I am a good candidate for the biopsy and that I get answers too.

thanks again!

Jump to this post

For another side to this issue, I have had small nodules since 1988. They are kept small by my taking Synthroid, because I was hypothyroid. My biopsy was so simple I hardly remember, it was done in the doc office and absolutely not painful. My thyroid blood levels are checked regularly and have always been fine. Have ultrasounds every few years. Nodules shrunk and remain insignificant.
Most nodules are benign.

REPLY
@valtron

Thank you for your response, I truly appreciate you sharing your experience with thyroid nodules.

They recommended another ultrasound in a year to check on the size, but nothing about a biopsy. I might just ask the endocrinologist if they can order one so I can have some piece of mind.

I'm thinking Hashimotos based on my symptoms, family history, and my latest thryoid test results. Of course I will wait until I can speak to a doctor about this, but I always like to gather as much info as possible going into these conversations!

Jump to this post

As someone who's had hashimoto's and nodules for almost 30 years, they are often or usually caused by hashimoto's. Your brain is basically telling your body to attack your thyroid gland, and nodules develop as a result. They can end up giving off extra thyroid hormone, making you feel hyperthyroid even though you've been diagnosed as hypothyroid. Confusing I know. Also just a note as one who's experienced this, a biopsy should never be difficult. I had one like that done by someone obviously inexperienced where I ended up weeping in my car bruised, bloody and in pain. Went to a doctor who knew what he was doing and he did one which was over before I even knew a needle was in my neck. Find someone who knows what they're doing and is a surgeon/ endocrinologist.

REPLY
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