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Forum Name: Head and Neck Cancer

Question: multinodular thryroid and subcentimetre lymph nodes


 freshy - Thu Sep 18, 2008 8:43 pm

Over the last 6 months i have had a feeling that something is stuck in my throat. So i went to see my doctor who sent me for a thyroid scan it turned out i had multinodular thyroid. So he sent me for a FNA the test results for that came back and they told me they were benign. And the doctor sent me to a specialist.
The specialist said my symptons sounded like Hashimotto's disease he also sent me for a CT scan with IV contrast which came back saying that i have no significant cervical lymphadenopathy with occasional subcentimetre lymph nodes noted likely reactive in nature unlikely to be significant. And the study is otherwise within normal limits what does this mean.
Also i am very tired all the time and have noticed a lot of bruises on my legs and arms and don't know how i get them.
 Dr. Safaa Mahmoud - Mon Oct 13, 2008 6:53 pm

User avatar Hello,

Hashimoto's thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease in which the body immune cells attack cells of the thyroid. This is a common cause of thyroid hypofunction. However, an increase in the level thyroid hormones released from the damaged thyroid gland occurs early in the course of this disease.

So patients usually present initially with thyroid gland enlargement make them feel throat tightness and swallowing difficulty. Patient then go into a phase of thyroid hypofunction, so they may complain of fatigue, depression, difficulty in concentration, dry skin and excessive sleepiness. Some patients have also antibodies that attack their platelets causing thrombocytopenia and easy bruise (an autoimmune thrombocytopenia).

Complete history, physical examination and investigations are essential for diagnosis and exclusion of other causes of thyroid dysfunction (benign or malignant).

Lab tests include thyroid function tests: T3, T4 and TSH. Typically, there is an elevated TSH while T3 and T4 are low (may be normal or high initially). TSH help determine if the cause of hypothyroidism is central (low TSH in hypothalamic or pituitary causes) or a primary thyroid disease (high TSH).

Testing for thyroid autoantibodies is also helpful to diagnose Hashimoto's thyroiditis.
Thyroid US and CT scan are recommended as needed. US is used to guide for thyroid FNA. Hashimoto thyroiditis is also diagnosed based on histology with diffuse infiltration of the thyroid gland with inflammatory cells.

Treatment is usually medical with hormone replacement according to symptoms and lab results. While surgery is kept for complicated cases.

I advise you to follow up with your doctor and to inform him with your symptoms.
Hope this information is useful.
Best regards.

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