74-year-old female with thyroid mass and neck adenopathy and priorCT. RIGHT LOBE MEASUREMENTS: 4.1 x 1.8 x 1.6 cmLEFT LOBE MEASUREMENTS: 1.8 x 1.8 x 5.1 cmISTHMUS MEASUREMENTS: 0.2-cmRIGHT LOBE: Heterogeneous in echotexture. Cystic nodule with comet tail artifactconsistent with colloid measuring 0.5 x 0.5 x 0.5 cm. Very small, hypoechoic nodulespresent as well.LEFT LOBE: Heterogeneous in echo architecture. Spongiform appearing lower pole nodulemeasuring 0.8 x 0.7 x 1 cm likely with comet tail artifact consistent with colloid nodule.Posterior solid nodule with internal dense rim calcification measuring 1.4 x 1.3 x 2.3cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Abnormal lymph nodes identified in the left neck including a round cystic --appearing level 3 node measuring 0.5 x 0.5 x 0.7 cm a round solid 0. 5 x 0.5 x 0.8 cmlevel 3 node and a predominantly cystic level floor/supraclavicular cystic node measuring0.9 x 0.9 x 0.9 cm. OTHER: No significant abnormality noted.
Solid left thyroid nodule with smaller nodules most suggestive of colloidnodules.Necrotic -- appearing left neck lymph nodes.US GUIDED FNA; 3/6/2015 12:46 PMCLINICAL INFORMATION AND PRE-OPERATIVE DIAGNOSIS: Thyroid mass, neck adenopathyPOST-OPERATIVE DIAGNOSIS : SameCOMPARISON: Same-day ultrasound, CT neck from 2/19/15OPERATORS: Doctors paushter; The attending physician, Dr. paushter, performed theprocedure. TECHNIQUE: Following a discussion of the procedure with the patient, including its risks,benefits, alternatives and steps to prevent infection, an informed written consent wasobtained and documented in the patient's chart. The time-out form was completed toconfirm patient identity and side/type of procedure.Localizing US demonstrated large solid left thyroid mass and necrotic -- appearing leftsupraclavicular lymph node. The skin over the target area was cleansed with chlorhexidine. Transducer was sterilelysheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, the thyroid lesion wassampled using 25 gauge needles. Two fine needle aspirations were performed. The leftsupraclavicular lymph node was sampled using 25-gauge needles. Four fine needleaspirations were performed.Cytology was present to confirm specimen adequacy. Specimen was handed to cytology. The patient tolerated the procedure well without immediate complications. Routine postprocedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 5 cc. An adhesive bandage was placed on the patient?sskin.