Please, help or assist! (RSHCHZ?)

[Leonn]

Please, help or assist!



To the wife 41 year.

Results of US of a thyroid gland:

THYROID GLAND: a locating usual. The form - usual. : 0,43, the right share - 4,71,61,7 sm, the left share 4,81,61,8 see Contours equal, precise. Structure or frame medium-grained, is diffusive or diffusively-non-uniform with alternating sites lowered, average and mixed ehogennosti, with plural anehogennymi reflections, with rassejanymi fibrous reflections of weak and average intensity.

NEOPLASMS: one; localization: an average segment of the right share. The sizes up to 0,49 see the Form spherical, contours equal, precise. Structure or frame homogeneous, raised or increased ehogennosti.

NEOPLASMS: two (confluent character); localization: the bottom segment of the left share. The sizes up to 1,82 see the Form ovoidnaja, contours rough, precise. Structure or frame non-uniform, mixed ehogennosti, with a zone of a cystic degeneration.

NEOPLASMS: one; localization: the bottom segment of the left share. The sizes up to 0,9 see the Form ovoidnaja, contours equal, precise. Structure or frame homogeneous, raised or increased ehogennosti.

Parashchitovidnye glands are not visualized.

Regionarnye lymphonoduses: from both parties or sides lymph nodes (on the right paratrahealnyj up to 0,6 sm, at the left paravazalnye up to 0,8 and up to 0,7 sm) with equal precise contours, the oval form homogeneous gipoehogennoj of structure or frame - similar on structure or frame are defined or determined.

The CONCLUSION: Diffusive or Diffuse augmentation of a thyroid gland. Sites of both shares of a thyroid gland. A chronic thyroiditis. Bilaterial cervical limfoadenopatija.



THE ANALYSIS OF THE BLOOD:

Thyritropic hormone (TTG) - 2,6 ??N/l

Trijodtironin the general or common (TZ) - 1,7 ???y./l

Thyroxine the general or common (4) - 112,5 ???y./l

Electrolytes (calcium C) - 2,13 ???y/l



The aim puncture biopsy under the O?-control of nodal education of the bottom segment of the left share of a thyroid gland is spent.

The CYTOLOGIC CONCLUSION: On a background of a blood gemosiderofagi, lymphoid elements of a different degree of the maturity, activly proliferating tireoepitely, an abundance In-cells, simplastov, cells vystilki cysts with atypia.



In addition, before it or this at inspection (US) at the gynecologist the conclusion is received: the Hysteromyoma of the small sizes in a combination to a genital endometriosis of the small form. A chronic adnexitis on the right, a cyst (follicular?) at the left.



If it is possible or probable, respond, please:

How much far all has come?

What treatment is possible or probable (only full excision SHCHZH?)

That can be expected?

Terribly...



Thanks.

Leonid

[VanushkoVE]

Indications to operative treatment develop by results of the cytologic research. The conclusion of the cytologic research should reflect the morphological diagnosis: a nodal colloid struma, an adenoma, an adenocarcinoma, a follicular neoplasia. The nodal colloid struma which makes up to 95 % of all nodal educations SHCHZH, far not always is a subject to operative treatment.

Any descriptive answer of a biopsy in all civilized world can be regarded as not informative.



Let's look or see your conclusion:



The CYTOLOGIC CONCLUSION: On a background of a blood gemosiderofagi, lymphoid elements of a different degree of the maturity, activly proliferating tireoepitely, an abundance In-cells, simplastov, cells vystilki cysts with atypia.



It neinformativno. There is no the cytologic diagnosis. Means, a biopsy it is necessary to repeat and-or consult glasses at the qualified morphologist. There will be the cytologic diagnosis, there will be precise medical tactics.

[Leonn]

Thanks, we shall try to consult glasses once again and then to repeat a question.

[Leonn]

Hello!

After viewing glasses in laboratory of an oncologic dispensary has been diagnosed: a chronic thyroiditis yes Kervena.

The surgeon-oncologist has told or said, that the bases for an operative measure he does not see also treatment should be appointed or nominated by the endocrinologist, and for the control of size of sites over 3-4 months is spent by US.

The endocrinologist has appointed or nominated reception of a L-thyroxine.

Whether it is enough of it or this for a stunt of sites? Perhaps, it is possible to make something or something else? Whether we waste time?



Thanks,

Leonid

[VanushkoVE]

Look or See for the beginning this (http: // thyronet./imgz/thyr_broch_19.swf) and this (http: // obi.img.ras.ru/Humbio/ECLIN/0020c72f.htm) the information.

[Leonn]

Look or See for the beginning this (http: // thyronet./imgz/thyr_broch_19.swf) and this (http: // obi.img.ras.ru/Humbio/ECLIN/0020c72f.htm) the information.

Thanks, has closely seen or overlooked links. Unfortunately, I am far from medicine, therefore questions have remained.

1. How much or As far as in general it is possible to trust the put diagnosis? The Part of signs (temperature 36,9, the general or common bad state of health, a laryngitis, the general or common pohudanie) took place, but the pain (at least strong) was not. Or the cytologic research + the US + the analysis of a blood unequivocally identify this type of disease and to doubts not a place?

2. Thyroiditis DeKervena in most cases recovers completely (whether though relapses are possible or probable, etc.)-means it, what sites disappear?

Our treating endocrinologist speaks, that sites on shchitovidke do not resolve.

3. *quot; Gipotireodnaja a stage... At this time spend replaceable therapy levotiroksinom... *quot; - i.e. treatment to us is appointed or nominated correctly? What its or his result should be?



If it is possible, please, respond.



Thanks.

Leonid

[VanushkoVE]

I shall try to respond, how much or as far as it allows virtual consultation.

1. The Diagnosis of a subacute thyroiditis raises the doubts, but I can be mistaken.

2. True sites at a subacute thyroiditis do not happen. If they are, it is a question of a combination at least two diseases.

3. Level TTG of a blood 2,6, i.e. normal. Means speeches about gipotireoidnoj stages cannot be. SHCHZH functions normally. Hence, levotiroksin it is not necessary.

I recommend to repeat a biopsy in the qualified establishment.

By the sizes from the report of US volume SHCHZH nearby 14 ml. It means, that augmentation SHCHZH is not present (norm or rate for women up to 18 ml).

[yananshs]

If it is possible or probable, respond, please:

How much far all has come?

What treatment is possible or probable (only full excision SHCHZH?)

That can be expected?

Terribly... It seems to Me, first of all it is necessary will calm down to you, and to calm the wife. Function of a gland - in norm or rate, volume of a gland in norm or rate. Nodules in a thyroid gland happen very much at many, and the majority of people about it or this do not know and never learn or find out. Is not present nikakoh the bases to do or make US to all people on a planet in searches of these nodules. To your wife of US it has been made. We do not know, what were for this indication. Therefore you now know, that it or she has nodules. But into a panic in this occasion to run it is absolutely not necessary. There is a rule - punktirovat sites exceeding the certain size. In the Europe as a rule it is accepted punktirovat the sites exceeding 1. The problem or task of a puncture to define or determine high quality of the site (nodules are good-quality in overwhelming majority). If they are good-quality - to do or make it is not necessary ANYTHING if certainly sites do not stick out and do not spoil a neck. About DeKervena it is necessary to forget, in my opinion. Now its or his any clinical attributes are not present, and to treat it is necessary nothing.

The thyroxine, seems to me, is not necessary absolutely. There were attempts to reduce sites by means of a thyroxine Earlier, but it has appeared, what is it most likely it is senseless.

[Leonn]

I thank for answers, many thanks!

Two more, can, a silly question - and whether there are now any methods of decrease of the sizes of sites on SHCHZH, or only observation over their body height? And whether it is necessary to repeat periodically a puncture, i.e. whether there can be a good-quality site malignant?



Leonid

[yananshs]

Sites to reduce it is not necessary. Good-quality sites not ozlokachestvljajutsja.

[Leonn]

Sites to reduce it is not necessary. Good-quality sites not ozlokachestvljajutsja.



All is clear, once again many thanks!



Leonid