This mass showed up on a cartoid us. Upon having a f/u us of the thyroid my L side was found to be dominated by s complex multi-septated cystic and solid mass which demonstrates evidence of mild intra-nodular vascularity approx 2.7 x 4.3 x 2.8 cm. Also within the Isthmus there is an additional hypoechoic nodule 1.3 x 1.6 x 0.7 cm. FNA recommeded. FNA reports The follicular epithelial cells are mostly arranged as two dimensional fairly orderly sheets but some syncitial groups are also present. There is nuclear enlargement in many of the groups. Papillary architecture and defining intranuclear inclusions are not apparent. Colloid is scant.
The cellularity of the specimen, scarcity of colloid and nuclear enlargement are concerning for neoplasm including papillary carcinoma, but diagnostic changes are not apparent.
My PCP referred me to ENT whom seemed very nonchalant and states that it "probly isn't cancer" and no rush yet it will need to be removed and his surg sched is booked out until August, not to worry and its ok to wait.???? I am very concerned and confused. My labs were all w/in norm range, yet symptoms are driving me crazy and I just want it out. I am tired, I have pain in my neck and under my jaw area, I cant swallow very well and cough and choke a lot and my voice keeps going away on me.
I have a medical background, yet the cytology report is somewhat foriegn to me! Please help me by putting it into laymans terms! Any advice or interpretation will be much appreciated.
thyroid cytology is not simple. The are describing some potentially suspicious cellular changes but not enough to call outright cancer. Likely it is in the "atypical" category -- but given the size and symptoms, surgery is usually recommended rather than repeat FNA w/ molecular markers in 2-3 months route that we often due for small "atypical" nodules. Would consider a second opinion if there is another good thyroid surgeon in your area, given that you are having symptoms.
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