Male 62 years old Reason: MTC; mapping ultrasound History: MTC; mapping ultrasound RIGHT LOBE MEASUREMENTS: 5.4 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.3 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.12 cmRIGHT LOBE: In the mid right thyroid lobe is a hypoechoic irregular nodule measuring 0.9 x 0.9 x 0.9 cm with questionable punctate calcifications. Adjacent and deep to this hypoechoic nodule is a more solid-appearing nodule measuring 1.2 x 0.8 x 0.9 cm.LEFT LOBE: Hypoechoic nodule in the left inferior thyroid lobe measures 0.6 x 0.6 x 1.0 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a very large heterogeneous right level 2 lymph node measuring 5.3 x 3.8 x 3.3 cm. There is a enlarged right level 3 lymph node measuring 2.0 x 1.0 x 2.3 cm. There is also an enlarged left level 3 lymph node measuring 1.1 x 0.5 x 1.0 cm.OTHER: No significant abnormality noted.
1.Hypoechoic irregular nodule in the right thyroid lobe is concerning for malignancy, and may be the primary, given history of MTC. 2.Very large right neck lymph nodes are concerning for metastatic disease. Enlarged left neck lymph nodes are also concerning for metastatic disease.