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SOLID MASS WITH CYSTIC COMPONENT in thyroid ULTRASOUND.

Resolved Question:

My wife is in Philippines and had a ultrasound done on her thyroid. The findings were:

The right thyroid lobe measures 5.3 x 1.6 x 1.9 cm with a solid mass at the superior pole measuring 1.6 x 1.1 x 1.4 cm. The left thyroid lobe measures 5.7 x 1.7 x 1.7 cm with a solid mass with cystic component at the middle 3rd measuring 1.6 x 1.4 x 1.2 cm. The isthmus is not thickened.


What does this really mean and is it a concern?

I mistakenly omitted this part:

Solid nodules, both thyroid lobe with cystic degeneration on the left.


Category: Nephrologist

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Category: Pediatric Nephrologist
Dr. Sree Bhushan Raju is online now

Expert:  Dr. Sree Bhushan Raju replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
The MRI of the kidneys is suggestive of polycystic kidney disease. Before I mention the treatment and prognosis, can you give me a detailed medical history -
1) Why did you get the MRI done? What were the symptoms?
2) Any history of hypertension/ anemia?
3) Has serum BUN, creatinine been evaluated?
Any other medical history such as T2DM or cardiac ailments?
Also is this the first MRI of your kidneys?
Kindly provide me the details for me to be able to help you,
Regards.


Patient replied :

I had the MRI done because I was having pain in my back. Yet, it was done by a back specialist because I thought it had something to do with my.spine. When he looked at the cd he saw the cysts and advice me to go see a specialist. So I went to the urologist who sent me the MRI.They did some blood work but I dont know the results yet. I've never suffered from hypertension, but I did have high blood pressure when they checked it at tbe urologist office. No cardiac problems or anemia. I did have a lot of pain in my back and now that pain sometimes moves to the front. Every so often when I'm driving I feel a sharp throb that goes from my back to the front and it's very bothersome. I hope this.helps. Thank you


Expert:  Dr. Sree Bhushan Raju replied 3 Days.

It looks like you have cystic disease of the kidney. Not to worry about the label given to your condition. Cysts is a thin round structure contains fluid. It can be of any size but of no clinical importance, called simple cortical cyst unless it produces pressure effect of the adjacent organs or bleeds inside. The cysts in your both kidneys developed a bit if bleeding which us very common for many large cysts and makes them ' a complex cyst'. You had pain as it was bleeding inside the cysts leading to a stretch that can produce pain. Otherwise you wouldn't have had any symptoms even throughout your life. You need to worry about this as pain subsides automatically. Must important thing is that
1. You have high BP or not. It makes a difference. So if the BP is adequately maintained and under control it won't be a problem.
2. How many cysts each kidney has got. The clinical relevance of this observation, I can explain to you if you provide the following information
- any one in your family has kidney disease , is your BP still high , any one in your family suffers from similar type of cysts in the kidneys?
Regards.


Patient replied :

No, no one in my family has that. I investigated, but no. Either way, I can't really know because I don't know part of my family. I was adopted by an aunt and only know some things. Why would that make a difference? I have 7 on my right kidney and 3 on my left. I also had an ultraound done where it states: Right kidney: In the upper pole there is a parenchymal cyst measuring 1.2 x 1.1 x 1.0 cm. In the midpole there is a 1.1x1.0x0.6 cm cyst which has kayering echogenic material consistent with milk of calcium. Left kidney: there is a septed complex cyst measuring 1.4x1.0x1.2 cm. In the midpole there is a cyst 6-7mm with a peripheral echogenic focus likely related to milf of calcium. My concern is that I've been reading a lot about kidney cysts. I always find there's more concern over complex cysts that simple cysts. According to the MRI, which I find is more accurate, there's no mention of simple cysts. All they talk about are the complex cysts. I don't know if thise are the ones made of calcium. I'm not a doctor, I just like to investigate to know what it's going on. I don't have patients to wait until I see the doctor again.


Expert:  Dr. Sree Bhushan Raju replied 2 Days.

Hello,
Thank you for the follow up.
Don't worry. Simple cysts do not require MRI and complex cysts have to be explored further by MRI and thus the difference . Complex guest mean a major problem or a disease. Several cysts on both sides if any age group makes us suspect a condition called autosomal dominant poly cystic kidney disease
Regards.


Dr. Sree Bhushan Raju
Category: Pediatric Nephrologist
Experience: 
FISN : Fellowship of Indian Society of Nephrology(ISN), 2012
FIACM : Fellowship of Indian Association of Clinical Medicin(IACM), 2012
FICP: Indian College of Physicians Association of Physicians of India, 2012
Fellowship: DM, DNB, All India Institute of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, Nizam's Institute of Medical Sciences, 1998
Medical School: MBBS, Gandhi Medical College, 1994
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