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Sonogram

Baldy's picture
Baldy
Posts: 226
Joined: Mar 2011

I had my first post-operative sonogram on 12/5/2012 and unfortunately the results aren't as sclean as I would like. Two nodes were found to be abnormally large, both in my right neck. One at level IV which was round and 3mm which doesn't "demonstrate a fatty hilum" and one at level VI which was oblong 4mm x 3mm and does "demonstrate a fatty hilum."

From Googling I find that the absense of a fatty sheath {or hilum} around a lymph node and a spherical shape can be indicators of a cancerous node. So the one at level IV, which the report calls "suspicious" could be residual cancer. The other which does have a fatty sheath, is oblong and the report merely states "attention for followup studies recommended" is likely swollen from an infection {I did have a sinus infection some weeks before the sonogram.} A good sign is that all my blood levels are consistent with no cancer. However, my endo explained it's possible that the blood levels could be decieving.

The current recommendation is to "wait and see" and have another sonogram in six months. I'm not comfortable with the thought that if this is residual cancer, it may very possibly metastisize {if it already hasn't} while I'm "waiting and seeing."

Hopefully this is all leftover from the sinus infection and I'm fretting over nothing.

 

Alan

 

PS Historical info:  Papillary Stage III - Total Thyroidectomy 2/8/10 with 4 foci .7mm to 2.6mm -  55 lymph nodes removed right neck two of which were found to cantain cancer cells.

amorriso
Posts: 186
Joined: Oct 2010

Hi there.  Two years ago I too had strange looking lymph nodes both a PET scan and ultrasound pointed to a return. - my surgeon opted to remove them to be safe rather than wait and they tested negative for cancer. It was a condition called reactive hyperplasia.  Big big relief!

My suggestion.... push for a needle biopsy if the nodes are located in a suitable area, push for another ultrasound in two or three months and go from there.  Seeing as you had a sinus infection - they could just be reacting to that. 

Hoping for the best

 

Baldy's picture
Baldy
Posts: 226
Joined: Mar 2011

Hi amorriso,

I have a pre-existing follow up appointment with my head and neck surgeon scheduled for mid-January, I had already intended to do pretty much what you're suggesting with him {though I hadn't thought of a fine needle biopsy.}  I had already talked to him on the phone immeadiately following the sonogram and he agreed with the wait and see diagnosis my endo suggested.  He normally has an aggressive approach, but he also usually defers to the endo who is pretty well known.  Hopefully I'll be able to sway him.

Thanks for the reply,

Alan

Baldy's picture
Baldy
Posts: 226
Joined: Mar 2011

Hi all,

After speaking with the head and neck surgeon, I reluctantly agree with the wait and see diagnosis.

As he explained, someone who has already had major surgery in the area where the suspicious nodes are, runs an increased chance that further surgery will cause incidental damage.  When the initial surgery is done, the surgeon does his best to put all the nerves and vessels that he had to move aside back in their original positions, but sometimes they aren't quite where they should be.  If you go back in, with scaring from the previous surgery and the possibility that nerves and vessels may be out of place, the risks are greater than they were the first time.  Since my impression is that he's on the aggressive side, I'm going to proceed as he and the endocrinologist advise.

Also, he feels the nodes are too small and deep to do a fine needle biopsy.

Sorry to be so late with this info.

Alan

Baldy's picture
Baldy
Posts: 226
Joined: Mar 2011

Hi all,

It's been six months and I've had my second sonogram.  The results were both good and bad.  One of the two nodes from the first is definately gone.  There is a node of aproximately the same size in the same area as the other.  There are also several new nodes showing up, one of which is large enough to feel by hand, at Level V, almost out on my shoulder.  I think I'm more worried about the probable repeat than the new ones, the surgeon said the new ones will be easy to remove if it comes to that.

Again, the recommended course of action is "wait and see" with another sonogram in six months.  I really, really hate "wait and see".

Alan

Baldy's picture
Baldy
Posts: 226
Joined: Mar 2011

Hi all,

I thought I'd keep you informed so that maybe my experience with follow up sonograms may be of some help.

Just had my 3rd Sonogram, the single node that was in both the 1st and 2nd sonogram didn't show up in the 3rd which I'm very happy about.  The enlarged group that showed up in the 2nd showed up again in the 3rd, BUT they are not spherical and my endo says not to worry about them.  The 3rd also showed 3 other enlarged nodes in 2 different locations that were also not spherical and are therefore not a problem.  He's satisified enough with the results to extend the wait time for my 4th sonogram from six months to nine months.

For your peace of mind, don't listen to anything the sonogram techs say while they're doing the scan.  When I had my 2nd sonogram, the techs were asking questions and making comments that made me believe that not only was there residual cancer, but it was in both sides of my neck.  When I talked to the Dr three days later, he told me there was no evidence of residual cancer and there were no enlarged nodes at all on the one side of my neck!  They aren't supposed to comment while they're doing the scans, and they shouldn't ask questions either since the patient {me in this case} can jump to conclusions based on the questions they ask.  This wasn't a problem this time, both because I had learned my lesson and the tech who did the scan was professional enough not to comment and the only questions she asked were general.  But the 2nd time, I had an anxious 3 days while I waited to talk to the Dr about the results.  Don't put yourself through that if you don't have to!  Wait for the Dr to tell you the results!

Alan

 

amorriso
Posts: 186
Joined: Oct 2010

Hi there.  Two years ago I too had strange looking lymph nodes both a PET scan and ultrasound pointed to a return. - my surgeon opted to remove them to be safe rather than wait and they tested negative for cancer. It was a condition called reactive hyperplasia.  Big big relief!

My suggestion.... push for a needle biopsy if the nodes are located in a suitable area, push for another ultrasound in two or three months and go from there.  Seeing as you had a sinus infection - they could just be reacting to that. 

Hoping for the best

 

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