腫瘤醫生請看甲狀腺結節

REASON FOR EXAM: 240.9 Thyroid goiter.

2011年底超聲發現多發結節，已經超了4次。 每次都大一點，這次是比較一年前的。我這樣一定要做活檢嗎？謝謝大家！


TECHNIQUE: A high-resolution transducer was used to scan the thyroid.

COMPARISON: June 18, 2013.

FINDINGS:

Right lobe: 5.7 x 2.5 x 2.5 cm.
Echotexture: Mildly heterogeneous.
Masses: 
1. There is a dominant, heterogeneous, predominantly solid, partially cystic nodule in the
mid-thyroid lobe. This nodule is slightly hypoechoic to the thyroid parenchyma and 
measures 3.1 x 2.2 x 2.3 cm. This nodule previously measured 2.4 x 2.1 x 2.4 cm. No 
microcalcifications are visualized. The nodule is wider than tall. Internal flow is 
visualized with color imaging.
2. In the lower pole, there is a small hypoechoic to anechoic cystic nodule that measures 
4 x 3 x 3 mm and previously measured 3 x 3 x 3 mm. No microcalcifications are visualized. 
There is no internal flow with color imaging.
3. In the lower pole, there is a 6 x 6 x 4 mm, predominantly cystic, partially solid 
nodule that previously measured 4 x 5 x 4 mm. No microcalcifications are visualized. There
is no internal flow with color imaging.
4. In the medial lower pole, there is a hypoechoic nodule that measures 3 x 4 x 2 mm. This
nodule is unchanged in size. No microcalcifications are visualized. There is no internal 
flow with color imaging.

Left lobe: 5.2 x 1.7 x 1.5 cm.
Echotexture: Mildly heterogeneous.
Masses: 
1. In the mid to lower pole, there is a mixed, predominantly solid, partially cystic 
heterogeneous nodule that measures 1.0 x 1.0 x 0.7 cm and previously measured 1.0 x 1.0 x 
1.1 cm. No microcalcifications are visualized. This nodule is slightly wider than tall. 
There is no significant internal flow with color imaging.
2. In the medial lower pole, there is a heterogeneous hypoechoic nodule that measures 1.1 
x 0.8 x 0.5 cm. The margins of this nodule are mildly indistinct. This nodule is not 
identified on the prior study. There are no microcalcifications. There is no internal flow
with color imaging.
3. In the lower pole, there is a mixed heterogeneous, predominantly solid, partially 
cystic nodule that measures 5 x 4 x 4 mm. No microcalcifications are visualized. This 
nodule is not measured on the prior study.
4. In the upper pole, there is a cystic nodule that measures 5 x 5 x 2 mm. This nodule 
previously measured 3 x 3 x 2 mm. This nodule is wider than tall. No internal flow is 
visualized with color imaging. There are no microcalcifications visualized.

Isthmus: 5 mm in AP diameter.
Masses: In the left mid-isthmus, there is a solid hypoechoic nodule that measures 1.3 x 
1.0 x 0.5 cm and previously measured 1.1 x 0.9 x 0.3 cm. No microcalcifications are 
visualized. This nodule is wider than tall. A small amount of internal flow is visualized 
with color imaging.

Color imaging: There is homogeneous vascularity.

IMPRESSION: 
Multinodular goiter. As there has been interval enlargement of the dominant nodule in the 
right thyroid lobe, recommend further evaluation with ultrasound-guided fine needle 
aspiration.