Thyroid Ultrasound Results: Understanding Hypoechoic Nodules and Neck Swelling

Question
Dear Doctor,
I have noticed swelling in both lymph nodes on each side of my neck below each ear. After 10 days of taking ceftin, nodes were still swollen so I had an ultrasound of each side of my neck and my thyroid.( I also had CBC and thyroid blood test and all returned normal) here is the results: palpable lump below rt. earlobe. rt lobe of thyroid is 4.6x1.6x1.5cm and is grossly homogeneous. Hypoechoic nodule focus inferior to rt. earlobe in area of palpable lump 1.3cm in size, appearance of lymph node. Left lobe of thyroid 4.2x1.4x1.2cm is grossly homogeneous. Hypoechoic focus measuring 8mm, appearance of lymph node. Hypoechoic heterogeneous lesion in rt. side of isthmus 1.8cm. Impression: Heterogeneous hypoechoic nodule in side of isthmus. Malignany cannot be ruled out. Biopsy can be performed. Slightly predominant lymph nods in neck bilaterally.
Please put this in PLAIN ENGLISH for me!!  even my Dr. couldn't do that!

Answer
The lumps you have felt on both sides appear to be lymph nodes in the scans (they are 13 mm and 8 mm in size, 1 inch = 25.4 mm), They can be investigated further by needle biopsies (ultrasound or palpation guided). Your thyroid is normal except that there seems to be a lesion of some sort close to its middle (its isthmus) on the right side, 18 mm in size. Malignancy there can not be ruled out. I too suggest a biopsy there. Easiest as an ultrasound guided needle biopsy. Good luck!


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