A 36 year-old lady presented with palpitations, sweating, and hypertension.
Lab Findings: TSH 0.05, T4: 12.5 . A thyroid scan and uptake scan were (Image 1): 2 hr uptake: 20% (Normal = 5-15%), 24 hr uptake: 40% (Normal = 15-35%) . The patient was then treated with 10 mCi I-131. The patient returned 4 months later with significant improvement of symptoms, TSH 2.5, T4 11, Thyroid uptake and scan (image 2): 2 hr uptake: 8%, 24 hr uptake: 20%.
What is the most likely diagnosis for the finding in Image 1?
ACNM Spotlights May 2017 Case
Autonomous Nodule: Plummer's disease. The function of rest of the gland is suppressed due to TSH suppression by feedback mechanism.
Graves disease vs toxic goiter.
Ultrasound: A solitary nodule in inferior pole of left lobe. Thyroid scan: A solitary functioning nodule with no function in the rest of gland. Post-therapy: The nodule showed no function, and the gland showed uniform uptake.