Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Follicular Lesion with Hurthle cell change and Cytologic Atypia?
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Follicular Lesion with Hurthle cell change and Cytologic Atypia?

I am a 57 year old woman with hypothyrodism, which was diagnosed in 2003.  At that time I had a nodule 1.8 cm on the right lobe.  We recently found it was now 2.1 cm and I went for a biopsy.  The clinical impression was benign and the diagnosis reads atypical cells seen - Follicular Lesion with Hurthle cell change and cytologic atypia.    It then reads that the semars are mildly cellular and show epithelial shows arranged in microfollicular clusters...most groups show hurthle cell features.  The nuclear features show areas of crowding and occasional nuclear grooves.  No overt papillary cytologic features are noted.  A hurthle cell neoplasm is not entirely excluded.  Although there are areas of cytologic atypia, no overt evidence of malignancy is seen.  Close Clinical followup is suggested.  

My endincronologist referred me to a surgeon.  I am reading this report to mean that the nodule is benign but there is some possibility of pre-cancer in the nodule.   And I guess I will have to have it removed.

Can you shed any light on what exactly is going on here?   Thank you.
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Would have slides sent to U Florida (Dr. Massoll) or Johns Hopkins for second opinion - with the crowding and grooves, these are potentially suspicious - if the second opinion agrees then removal is necessary for a diagnosis.  You may have Hashimoto's which could explain the hurthle cell changes.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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