76 year-old female with primary hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 5.2 x 1.5 x 1.9 cmLEFT LOBE MEASUREMENTS: 4.4 x 2.1 x 1.4 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: The right thyroid lobe is heterogeneous in appearance with several spongiform nodules and sub-centimeter hypoechoic nodules. In the superior pole of the right thyroid lobe is a coarsely calcified .9 x .8 x 1.1 cm nodule whose visualized margins are well-defined. LEFT LOBE: The right thyroid lobe is heterogeneous in appearance with several spongiform nodules and sub-centimeter hypoechoic nodules. The largest nodule measures 1.3 x 0.9 x 1.1 cm in the inferior pole with a spongiform appearance, compatible with a colloid nodule. ISTHMUS: The isthmus is heterogeneous in appearance with no discrete dominant nodule. PARATHYROID GLANDS: Immediately caudal to the right thyroid lobe is a 0.9 x 0.8 x 1.1 cm hyperechoic mildly vascular focus. Similarly, there is a 1.1 x 0.6 x 0.8 cm hyperechoic avascular focus immediately caudal to the left thyroid lobe.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Hyperechogenic foci immediately caudal to the right and left thyroid lobes are non-specific and can represent focal fat; the appearance would be atypical for parathyroid adenomas. Correlation with a nuclear medicine parathyroid scan is suggested.2. Coarsely calcified 1.1-cm right superior pole nodule. Fine needle aspiration should be considered. 3. Multiple bilateral subcentimeter nodules, many of which have a characteristic spongiform appearance of colloid nodules.