So, what would you do with a report in your hand from a radiologist that had terms like, "heterogeneous echotexture" and "normal vascularity"? The curious side of me wants to know what everything means. I want to understand the report. So... I did what anyone would do (okay, maybe not anyone) I Googled ALL of the terms on the report until I had translated it completely into plain English.
Without going through all of the specifics, here is a summary of some of it.
The lump they originally scanned is a lymph node, measuring 1.65 X .6 X 1.2 cm It had no indicators of any abnormal tissue or cells. They recommend rechecking it in 2 months to be sure.
My 2 major lymph nodes were also scanned both were found to be normal, no abnormal tissue, although one is significantly larger than the other.
3 nodules (lesions/nodes) were found.
1 on the lower right side of my thyroid (1.3 X .9 X 1.0cm) - We'll call this "A"
1 on the midsection of my left side of my thyroid (2.4 X 1.4 X 1.7cm) We'll call this "B"
1 on the lower left side of my thyroid (1.9 X 1.9 X1.7cm) - We'll call this "C"
There were other terms that I saw that described the nodules. These terms are ones that both gave me hope (in some circumstances) but totally made me see why I needed the biopsy. Below are the definitions, as I understand them - no, they are not totally scientific.
Circumscribed: You can see a clear border. This is not always the case with malignant nodules, but usually the case with benign ones. ALL 3 of my nodules were circumscribed... HOPE!!
Hypoechoic: This tissue does not bounce back the sound waves as readily as the surrounding tissue.
According to one website, having this feature increases the risk of malignancy by 26%.
Calcifications: Having hardened deposits within the nodule. Having this feature (specifically mircocalcifications OR punctate calcifications) increases the risk of malignancy by 75%.
Vascularity: Having blood flow run through the nodule, not around it. Most benign nodules redirect the blood flow, malignant ones incorporate it. So, having the absence of this increases my chance of it being benign. This in, conjunction with something else, is a good predictor of malignancy. It is found on about 50% of malignant tumors.
Size and Shape: Most benign tumors are wider than tall, shaped more like pancakes, sort of. Mine are all nearing rounded. Anything above 2cm, or around there, really requires a biopsy.
So... having 1 of these things, would make the doctor think carefully about his recommendations. Having 2 or more would mean he definitely needed to recommend the biopsy.
Nodule A: Hypoechoic, nearing rounded, but not quite
Nodule B: Vascular, Hypoechoic, over 2cm.
Nodule C: Punctate calcifications, almost perfect sphere
So, there you have it. My undergraduate research report on radiological terminology.
Based on my understanding of the ultrasound report, I would have recommended a biopsy, too.
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