|
Follow Up Investigation : |
USG OF THYROID (03-05-2000)
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of
thyroid shows multiple round hyperechoic masses which are joined together.
Some of these shows central hypoechoic areas, Suggestive of Necrosis.
Right lobe shows a 12x 10 mm hyperechoic nodule in lower pole.
Right lobe measures : 50x 60x 20 mm
Left lobe measures : 80x 35x 40 mm.
Isthmus measures : 8 mm.
Vascular structures and neck muscles are normal
No lymphadenopathy.
IMPRESSION:
Enlarged thyroid, multiple hyperechoic masses in left lobe are
consistant with CA thyroid.
USG OF THYROID (30-06-2000)
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of
thyroid shows multiple round hyperechoic masses which are joined together.
Some of these shows central hypoechoic areas, Suggestive of Necrosis.
Right lobe shows a 12x 10 mm hyperechoic nodule in lower pole.
Right lobe measures : 48x 20x 30 mm
Left lobe measures : 80x 35x 40 mm.
Isthmus measures : 8 mm.
Vascular structures and neck muscles are normal
No lymphadenopathy.
IMPRESSION:
Enlarged thyroid, multiple hyperechoic masses in left lobe are
consistant with CA thyroid.
(No increase since last USG).
USG OF THYROID (02-08-2000)
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of
thyroid shows multiple round hyperechoic masses which are joined together.
Some of these shows central hypoechoic areas, Suggestive of Necrosis.
Right lobe shows a 12x 10 mm hyperechoic nodule in lower pole.
Right lobe measures : 46x 17x 15 mm
Left lobe measures : 80x 33x 40 mm.
Isthmus measures : 7.8 mm.
Vascular structures and neck muscles are normal
No lymphadenopathy.
IMPRESSION:
Enlarged thyroid, multiple hyperechoic masses in left lobe are
consistant with CA thyroid.
(Minimal decrease in size since last USG).
USG OF THYROID (04-10-2000)
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of
thyroid shows multiple round hyperechoic masses which are joined together.
Some of these shows central hypoechoic areas, Suggestive of Necrosis.
Right lobe shows a 12x 10 mm hyperechoic nodule in lower pole.
Right lobe measures : 46x 17x 15 mm
Left lobe measures : 80x 33x 40 mm.
Isthmus measures : 7-8 mm.
Vascular structures and neck muscles are normal
No lymphadenopathy.
IMPRESSION:
Enlarged thyroid, multiple hyperechoic masses in left lobe are
consistant with CA thyroid.
(No Change since last USG).
USG of abdomen and pelvis (04-10-2000)
Liver is normal in size and shows hyperechoic echotexture suggestive
of fatty infiltration.Intrahepatic portal radicals are normal. No focal
lesion.
Portal vein
=10mms.
CBD = 3 mms.
Gall bladder is well distended with normal walls. There is no calculus or
sludge.
Pancreas is seen in its entirety and shows normal echoanatomy. Pancreatic
duct is undilated.
Mild splenomegaly. Spleen is 135 mm n length. No Focal lesion.
Right kidney measures : 95x 30
mms Left kidney measures :
100x 40 mms.
Both kidneys are normal in size, shape, position and echotexture.
Corticomedullary differenciation is well maintained. There is no calculus
or hydronephrosis.
Both ureters are undilated.
Aorta, IVC and paraaortic regions are normal.
No ascites or lymphadenopathy.
Urinary bladder is well distended with normal walls.
Uterus is not seen due to hysterectomy.
IMPRESSION:
Mild Splenomegaly.
Fatty infiltration of liver.
CT SCAN OF NECK & THORAX ( 06-11-2000)
FNAC suggestive of thyroid malignancy.
Plain and contrast enhanced CT scan of neck and thorax has been done.
Multiple sections at 10 mm interval have been taken before and after
injection of intravenous contrast.
Study reveals markedly enlarged left lobe of thyroid and isthmus measuring
4.9x 2.8 cms. in its maximum transverse dimensions showing subtle low
attenuation foci(cystic /necrotic components).
Enlarged lobe has extended across the thoracic inlet into superior
mediastinum (superioinferior extent of 7-7.5 cms) with the mediastinal
component measuring 4.7 x 2.8 cms. Splaing of the mediastinal vessles and
marked displacement of trachea to right of midline and posteiorly is
noted. Within the lower neck the trachea is displayed to rigth side.
The fat interface between the anterior and left lateral wall of trachea
and this lesion is obliterated.
Fat planes with the adjacent carotid sheath are preserved.
Small calcific specks noted within the lesion.
Right lobe of thyroid appears normal
There is no evidence of significant lymphnode enlargement in thorax/ neck.
Both the main pulmonary arteries are well seen and pre vascular spaces
appear normal.
The cardiac size and configuration is within the normal limits.
Both the lung fields appear normal. There is no evidence of any
parenchymal lesion or metastasis. ( Suboptimal lung images are due to poor
breath holding of patient).
The muscle planes are well maintained.
IMPRESSION :
Markedly enlarged left lobe of thyroid with cystic / necrotic foci and
a large mediastinal component causing compression / displacement of
trachea. The fat interface between the anterior and left lateral wall of
trachea and this lesion is obliterated.
No significant neck/thoracic lymphadenopathy noted.
Lung fields appear essentially normal.
USG OF THYROID (10/02/2001)
Known case of CA thyroid.
Follow up USG.
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of thyroid
shows multiple round hyperechoic masses which are joined together. Some of these
central hypoechoic areas, Suggestive of necrosis. Right lobe shows a 12 x 10-mm
hyerechoic nodule in lower pole.
Right lobe measures:46x 17x 15 mm
Left lobe measures :
8cm [Superoinferior]
3cm [Anterosuperior]
4cm [Transeverse]
Isthmus measures : 7-8mm
Vascular structures and neck muscles are normal.
No lymphadenopathy.
IMPRESSION: Enlarged Thyroid, Multiple Hyperechoic
Masses in Left Lobe Are Consistant With C A Thyroid. [Lesion Remains Static].
USG OF THYROID (10/04/2001)
Known case of CA thyroid.
Follow up USG.
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of thyroid
shows multiple round hyperechoic masses which are joined together. Some of these
central hypoechoic areas, Suggestive of necrosis. Right lobe shows a 12 x 10-mm
hyerechoic nodule in lower pole.
Right lobe measures: 46 x 17 x 15mm
Left Lobe measures:
8cm [Superoinferior]
3cm [Anterosuperior]
4cm [Transerverse]
Isthmus measures : 7-8mm
Margins of the gland are regular.
Vascular structures and neck muscles are normal.
No lymphadenopathy.
IMPRESSION: Enlarged Thyroid, Multiple Hyperechoic
Masses in Left Lobe Are Consistant With C A Thyroid. [Lesion Remains Static].
CT SCAN OF NECK/THORAX (26/06/2001)
A case of thyroid malignancy previous scan dated 06/12/2000 have been
reviewed. Plain and contrast enhancd CT scan of neck and thorax has been done.
Present study reveals soft tissue lesion involving the left lobe of thyroid and
isthmus extending into the superior mediastinum. This lesion in the lower neck
shows maximum transverse dimension of 4.9 x 2.7 cms and within the mediastinum
measures 4.6 x 2.9cms. Post contrast study reveals a mild inhomogeneous
enhancement pattern with necrotic/ cystic foci. Within the mediastinum the
mediastinal vessels and trachea are displaced to right of midline. Within the
lower neck the trachea is displaced to right side. The fat planes between the
anterior and left lateral wall of trachea and this lesion are obliterated. Major
neck vascular structures appear normal. No significant lymphadenopathy is noted
in neck / thorax. Mediastinal vascular structures appear normal. Heart and aorta
appear normal. No lung parenchymal lesion is noted to suggest metastasis. Bones
appear normal.
IMPRESSION : Follow up study does not reveal any significant change in size /
Appearance / Extent of the thyroid related lesion. No significant neck / thorax
/ lymphadenopathy noted. Lung fields appear normal.
USG OF THYROID (27/08/2001)
CA thyroid for review.
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of thyroid
shows multiple round hyperechoic masses which are joined together. Some of these
central hypoechoic areas, Suggestive of necrosis. Right lobe shows a 12 x 10-mm
hyerechoic nodule in lower pole.
Right lobe measures: 45 x 17 x 15mm
Left Lobe measures:
8.3cm [Superoinferior]
3.0cm [Anterosuperior]
4.0cm [Transerverse]
Isthmus measures : 8mm
Margins of the gland are regular.
No Focal lesion.
Vascular structures and neck muscles are normal.
No lymphadenopathy.
IMPRESSION: Enlarged Thyroid, Multiple Hyperechoic
Masses in Left Lobe Are Consistant With C A Thyroid. [No Significant Change].
USG OF THYROID (01/11/2001)
CA thyroid for review.
Thyroid was examined with 7.5mHz probe.
Left lobe of thyroid is enlarged and isthmus is thickened. Left lobe of thyroid
shows multiple round hyperechoic masses which are joined together. Some of these
central hypoechoic areas, Suggestive of necrosis. Right lobe shows a 12 x 10-mm
hyerechoic nodule in lower pole.
Right lobe measures: 45 x 17 x 15mm
Left Lobe measures:
8.3cm [Superoinferior]
3.0cm [Anterosuperior]
4.0cm [Transerverse]
Isthmus measures : 8mm
Margins of the gland are regular.
Vascular structures and neck muscles are normal.
No lymphadenopathy.
IMPRESSION: Enlarged Thyroid, Multiple Hyperechoic
Masses in Left Lobe Are Consistant With C A Thyroid. [No Significant Change].
CT SCAN OF NECK (28/12/2001)
A case of thyroid malignancy - previous scan dated
26/06/2001 has been reviewed. Plain and contrast CT scan of neck has been done.
Multiple sections at 5 mm and 7mm interval have been taken. Soft tissue mass in
left lobe of thyroid and isthmus measuring 4.9 x 3.4cms with extension in to
superior mediastium (4.9 x 3.7cms) showing mild inhomogeneous enhancement in
contrast study. There is compression and displacement of trachea to right side.
Vascular structures of neck appear normal. No evidence of cervical
Lymphadenopathy.Mediastinal fat planes are well maintained and appear normal. No
mediastinal lymphadenopathy. No evidence of pleural effusion. Visualised bones appear
normal. No lytic or sclerotic lesion is seen.
IMPRESSION : Soft Tissue Mass in left lobe of thyroid and Isthmus Measuring
4.9 x 3.4cms with extension in to superior mediastium (4.9 x 3.7cms) . No
significant change in size of the lesions as compared to previous scan report.
No evidence of Lymphadneopathy or Lung Metastasis.
CT SCAN OF NECK / THORAX (17/09/2002)
Case of thyroid malignancy. Previous scan dated 28/12/2001 has
been reviewed. CT Scan of neck has been performed. Multiple sections at 5mm and
7 mm interval have been taken. Study reveals soft tissue mass involving the left
lobe of thyroid and isthmus measuring 5.1 x 3.0cms with extension into
superior mediastnum (5.5 x 3.0cms) showing inhomogeneous enhancement and few
necrotic foci in contrast study. Compression and displacement of the trachea is
noted to the right side. Vascular structures of neck appear normal. No evidence
of obvious cervical lymphadenopathy. Strap muscles of the neck appear normal.
Larynx appears normal. Mediastinal vascular structures show normal anatomical
disposition. The trachea is central , both the main bronchi are well seen and
appear normal. The pre and para tracheal spaces and subcarinal spaces are well
seen and appear normal. The mediastinal fat plates are well maintained and
appear normal. Both the lung fields appear normal. There is no evidence of any
parenchymal lesion. The soft tissues are normal.
IMPRESSION : Soft tissue mass involving the left lobe of thyroid and
isthmus measuring 5.1 x 3.0cms with extension into superior mediastinum (5.5 x
3.0cms) showing inhomogeneous enhancement and few necrotic foci in contrast
study. No significant increase in size is noted as compared to previous scan
report dated 28/12/2001. No Lyphadenopathy / Pleural Effusion.
Thyroid Blood Test
| Date |
T3 |
T4 |
TSH |
Normal Range |
| 25/1/2000 |
126 |
8.60 |
1.71 |
T3 : 70-200 |
| 17/3/2000 |
125 |
7.11 |
0.48 |
T4 : 4.00 - 13.00 |
| 29/4/2000 |
167 |
10.49 |
0.14 |
TSH :0.30 - 7.00 |
| 29/6/2000 |
98 |
5.50 |
0.53 |
|
| 1/8/2000 |
109 |
7.60 |
0.35 |
|
| 2/10/2000 |
119 |
8.00 |
0.40 |
|
| 5/12/2000 |
129 |
7.90 |
0.49 |
|
| 9/2/2001 |
181 |
9.56 |
0.11 |
|
| 10/4/2001 |
117 |
7.20 |
0.31 |
|
| 26/6/2001 |
169 |
9.57 |
0.18 |
|
| 25/8/2001 |
119 |
8.10 |
0.39 |
|
| 1/11/2001 |
111 |
7 |
1.03 |
|
| 29/12/2001 |
153 |
10.50 |
1.19 |
|
| 1/3/2002 |
129 |
8.80 |
0.94 |
|
| 26/4/2002 |
175 |
9.36 |
1.03 |
|
| 9/7/2002 |
106 |
6.70 |
0.80 |
|
| 17/9/2002 |
150 |
10.30 |
1.14 |
|
| 14/11/2002 |
124 |
7.90 |
1.51 |
|
| 5/4/2003 |
124 |
7.55 |
0.95 |
|
|
Blood Test
| Date |
Hb |
Wbc |
Rbc |
ESR |
Normal Range ( for Female) |
| 7/2/2000 |
11.8 |
5200 |
|
|
Hb : 11.002 - 16.00 |
| 17/2/2000 |
13.8 |
7800 |
|
|
Wbc : 4000- 11000 |
| 17/3/2000 |
12.2 |
9600 |
4.10 |
47 |
Rbc : 3.82 - 5.80 |
| 10/4/2000 |
12.4 |
6000 |
|
|
ESR : 0 mm - 20 mm ( After 1 hour ) |
| 29/4/2000 |
13.10 |
8200 |
4.40 |
35 |
|
| 29/6/2000 |
12.70 |
9000 |
4.20 |
50 |
|
| 1/8/2000 |
12.20 |
7800 |
4.10 |
52 |
|
| 2/10/2000 |
12.20 |
8200 |
4.10 |
30 |
|
| 5/12/2000 |
10.00 |
8400 |
3.50 |
52 |
|
| 9/2/2001 |
12.20 |
8800 |
4.10 |
52 |
|
| 10/4/2001 |
13.10 |
9206 |
4.40 |
- |
|
| 26/6/2001 |
13.50 |
8600 |
4.50 |
45 |
|
| 25/8/2001 |
13.10 |
9400 |
4.40 |
56 |
|
| 1/11/2001 |
12.60 |
9200 |
4.20 |
50 |
|
| 29/12/2001 |
12.20 |
9000 |
4.10 |
55 |
|
| 1/3/2002 |
12.20 |
9200 |
4.10 |
45 |
|
| 26/4/2002 |
11.30 |
8400 |
3.80 |
50 |
|
| 5/6/2002 |
13.10 |
- |
- |
- |
|
| 9/7/2002 |
12.20 |
8200 |
4.10 |
43 |
|
| 17/9/2002 |
12.20 |
7800 |
4.10 |
25 |
|
| 14/11/2002 |
11.70 |
9400 |
3.90 |
35 |
|
| 5/4/2003 |
11.20 |
7200 |
3.70 |
40 |
|
|
|
