Hello doctor, I want to know what this report means so I can list my questions. I am concerned about the internal vascular nature of this report. I am attaching my last three ultrasounds. I am looking for your interpretation of the report and want to know if there is anything worrisome. I have attached two of my previous reports for comparison.
Hello,  Welcome to icliniq.com. From your attached ultrasound reports (attachment removed to protect patient identity), I understand that you have a thyroid swelling (goiter) with multiple tiny nodules for which you undergo regular followups. I can also see that these nodules are quite stable and have not undergone any worrisome change, nor have any cervical lymph nodes been found enlarged. But you are presently concerned about the structure with internal vascularity, which is a newer statement. It is quite natural to be worried about such a finding, but give me the pleasure of saying that it is only one of the four parathyroid glands that are attached very close to the thyroid. The internal vascularity is only an identifying point of parathyroids rather than any clue to an abnormality. The size of the parathyroid may raise suspicion as to whether it is enlarged, such as in parathyroid hyperplasia, adenoma, or carcinoma. However, parathyroid hyperplasia is accompanied by a finding of calcification in the gland, while carcinoma (cancer) is characterized by invasion into surrounding organs (your report says “which appears to be separated from …”). As for parathyroid adenoma, please be assured that this disease manifests itself quite clearly in clinical and labaratory features, such as abdominal pain (due to the formation of gallstones, renal stones), bone pain, abnormal calcium and phosphate levels, and altered parathormone. Therefore, considering all points, I would like to assure you that “internal vascularity” is not a cause of worry, and the parathyroid even if it is marginally enlarged should also not create anxiety unless your doctor finds features of hyperparathyroidism in your clinical or lab findings. Since I do not know your clinical or lab findings mentioned above, I suggest that you may clarify the matter further with your respective doctor during your next scheduled visit. I hope this helps.