I never thought that i will be undergoing surgery of the neck, not in my whole lifetime, surgery of the thyroid. I thought my thyroid was healthy. I never felt any difficulty in swallowing or breathing. I did not have any lump felt in my neck. I never had any symptoms of mood changes that come with thyroid disease. But, one fateful afternoon, a workshop for the new neck ultrasound machine in the hospital i worked for was done. In that workshop, volunteers were called to try the new machine. I volunteered hesitantly but with my friend's encouragement, i went and got checked by the machine.
The pictures above showed how they did the test. On the last picture, the monitor showed that they found a right thyroid nodule. Immediately, i went straight to another endocrinologist even though the neck surgeon told me that I can have it checked or just let it be as most of us have nodules in the neck. I decided to get checked by an endocrinologist.
The endocrinologist did some palpation. The nodule was too small to be palpated. He ordered some blood tests. The blood tests were normal - TSH, FT4 and FT3, all these tests for the thyroid were all normal.
The next visit, he did an FNA.
FNA - Fine Needle Aspiration biopsy.
According to Wikipedia. Fine-needle aspiration biopsy (FNAB, FNA or NAB), or fine-needle aspiration cytology (FNAC), is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin, hollow needle is inserted into the mass forsampling of cells that, after being stained, will be examined under a microscope. There could be cytology exam of aspirate (cell specimen evaluation, FNAC) or histological (biopsy - tissue specimen evaluation, FNAB).[1] Fine-needle aspiration biopsies are very safe, minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center, eliminating the need for surgery and hospitalization. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.[2]
The endocrinologist did an FNA. Just like a dart thrown on my neck and tried to get tissue samples from the nodule. He did succeed but the cytology revealed not enough tissue to make a diagnosis.
The doctor ordered ultrasound of the neck that revealed the nodule measuring 1.2 x 1.2 x 1.2 cm, round, hypoechoic without internal vascularity.
The endocrinologist told me that these types are suspicious for malignancy, so he wanted to get another FNA but this time ultrasound guided.
So, the doctor ordered again an ultrasound-guided FNA, again!
The ultrasound-guided biopsy was done in the Imaging Department by a radiologist with the ultrasonographers (there were 2) and cytologist to get the specimen. It took three times of pricking and probing to get a sufficient specimen.
The results came and it was really suspicious for malignancy. Thus, the nodule needed to be excised.
I was referred to the ENT surgeon.
