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nodule discovered during a carotid ultrasound scan

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Hello, I have a single nodule, left lobe, coincidentally discovered during a carotid ultrasound scan. I had another US of the complete thyroid a week after the carotid scan. It came back as this: "A single hypoechoic solid nodule with peripheral and possible internal microcalcifications is identified in the mid left lobe measuring .9 x 1.1 x .9 cm." I had FNA biopsy a week and a half ago, but it was unsatisfactory, so I am getting another, but I have to wait 6-8 weeks. My first question is, why the wait? Why can\'t it just be done a week or 2 later? Next question, from what I have read (e.g., Dr Jill Langer, Univ of Pennsylvania), microcalcifications + hyperechoic = 96% Specificity for cancer (ca. 2009?) I am curious as to your thoughts on this. (I am male, healthy, normal TSH, 46 yrs). I hate the thought of waiting 2 months if it seems so likely to be cancer. Is there really a good reason for such a long wait?

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replied May 2nd, 2013
Thyroid Cancer Answer A43225
Welcome to the ehealthforum and I am really glad to help you out.

Generally, benign nodules are hyperechoic and have a significant cystic component, a peripheral, eggshell-like calcification, a sonolucent rim, and well-defined margins; whereas malignant nodules are usually hypoechoic, have poorly defined margins, and may contain microcalcifications. Microcalcification within thyroid nodules may be associated with a higher risk of malignancy. Hence you need a repeat FNAB.

The diagnostic yield and accuracy of repeat FNAB is independent of the time interval between procedures but to avoid getting any false negatives, it is recom mended to wait for 6-8 weeks after the first biopsy.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care.

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