77-year-old female with primary hyperparathyroidism. Please evaluate. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.6 x 2.3 x 2.1 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.1 x 2.2 x 1.6 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.5 cm in thickness.RIGHT LOBE: There are multiple subcentimeter hypoechoic nodules with a spongiform appearance. The largest of these nodules measures 0.9 x 0.8 x 0.5 cm and is located in the anterior right upper pole.LEFT LOBE: Multiple subcentimeter hypoechoic nodules with a spongiform appearance. The largest of these nodules measures 0.9 x 0.7 x 1 cm and is located in the left lower pole. An additional complex cystic nodule posterior to the left mid thyroid lobe measures 1.5 x 1.2 x 1.4 cm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See below.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.
Complex cystic nodule posterior to the left mid thyroid pole could represent an exophytic cystic thyroid nodule, however a cystic parathyroid adenoma cannot be excluded. Correlation with nuclear medicine imaging is recommended.Multiple thyroid nodules bilaterally; favor benign etiology. 