Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Need explanation of FNA reult PLEASE HELP!
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Need explanation of FNA reult PLEASE HELP!

the following is what my fna results were....
could someone people exaplin to me exactly what they mean? my doctor has me scheduled for a thyroidectomy in two weeks. I want to know if i am doing the right thing.
THANK YOU SO MUCH FOR YOUR TIME!

FNA Final Diagnosis Comment
This aspirate exhibits a prominent, but not exclusive, Hurthle cell
population. In addition, there is at least moderate background colloid on
multiple smear preparations. Taken together, the cytologic findings are
most consistent with a benign colloid nodule exhibiting cystic degeneration
and prominent reactive Hurthle change. If the nodule continues to enlarge,
repeat aspiration could be considered.
97953_tn?1193367871
This is a relatively small nodule with a benign appearing FNA of a nodule that has undergone some cystic degenerative change (hence the reactive hurthle cells present).
Would repeat US in 6-12 months.
False negative rate for FNA is about 3-7% -- national average.
13 Comments
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Avatar_f_tn
i have also been hypo since i was about 16, and have been on synthroid for about 10 years. i have to admit that i have not always been consistant with my meds. i have gone a couple of weeks sometimes without taking it. but recently i have been very good about it.


my blood work is normal. well normal for me at least. i also have beta thalasemia.
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Avatar_m_tn
How big a nodule are we talking here? Other symptoms?
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Avatar_f_tn
through the ct they said 1.2 cm
through the ultra sound they said 1.4
no other symptoms really. i have been having some trouble sleeping at night. muscle soreness. and severe anxiety. i have dealt with anxiety for a while, but it seems ever since i found this, i have been panking a lot more about this.

i first noticed this in late october/early november. had such a bad panic attack thinking what i could be that my mom took me to the er. the dr there said that there was nothing. that it was "in my head" and that i should go seek acute psychiatric services. I told him that i feel something. there was something there. he said it was normal. but if i felt the need to go see a general family doctor.
when i went to the family doctor she laughed it off with "why are you worrying...my thyroid feels bigger than yours".
not satisfied with the answer, she said if i am really worried to go see an ent.
the ent could not feel anthing until i pinpointed to him what i was feeling and where. then he said "yup...something is there"
lets do a ct.
the ct found a well defined "mass" so we did the ultrasound and fna.
during the ultrasound the radiologist said it looks like a cyst. asked if i still wanted the fna, i said yes since i was already there and already preped.
from the fna... i got the above results.

i am worried about these hurthle cells. what do they mean? could it be a cancer... or precancer? or is it really benign?

i need answers to help alleviate my anxiety and fears....
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Avatar_f_tn
and if surgery will really help...
could it be worse after surgery?
is the surgery dangerous?
my mom was freaking ou becasue she says that is right next to all the arteries. and if they cut an artery i can die...

so any comments would really help!!!!
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1204245_tn?1356904325
The cytologist recommended follow up in 6 month; no surgery (although such recommendation must be made by endocrinologist).
Similar findings were discussed earlier on this forum
http://www.medhelp.org/posts/Thyroid-Cancer-Nodules--Hyperthyroidism/Biopsy-Report/show/600761
so you may PM the original poster about the final  outcome.
I would definitely recommend second opinion. If there is a disagreement between the endo and cytologist
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Avatar_m_tn
Offhand I would definitely get a second opinion.  Well actually if it were me, I'll tell the doctor to just watch it for a year or more.

My take:

Your cyst isn't that big.  
It's not cancer.
It's a cyst, meaning fluid filled.
Might resolve on it own.
Your labs are normal.

A thyrodectomy is serious life changing operation because then you're on meds for the rest of your life. And surgery *****.

It seems like there is no hurry to do anything right now.

PS: Also most thyroid cancer responds very well to treatment.  So your downside for just watching it isn't very high.  You can always have your thyroid out later if it's obvious it needs to come out.
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Avatar_f_tn
So what should I do? What would happen if I I'd not go through with the surgery and left it?
Would it get worse? Go away? In 12 months if its the same ... Then what?
I have second thoughts about surgery... The only reason I want to do it is to prevent anything bad like cancer from forming.
I'm looking at the procedure as preventative now. Would that be wise?
Also, what would happen if I wanted to get pregnant in the next year. Whether I decided to remove it or not.
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97953_tn?1193367871
If the nodule is not causing any pressure symptoms and the FNA favored a benign process, we usually watch these w/o surgery.  Most of these don't change much in size however they also don't frequently go away on their own.
Surgery is not without complications, so without a compelling reason, you may want another opinion prior to committing to surgery.
I would not think the possible pregnancy should influence this decision making with a benign appearing FNA.
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Avatar_m_tn
> The only reason I want to do it is to prevent anything bad like cancer from forming.

Well I have a 6cm cyst on my thyroid. With normal labs. Second biopsy is benign. I would describe the compression symptoms as 'mild'. Your cyst is much smaller than that.  Doesn't mean you can't fell it. But likely not causing you anything but worry.  My impression is that the pathologist and endocrinologist are annoyed with mine because it's big. I suspect because I'm not panicking they aren't either.

If you read the American Thyroid Association guidelines for thyroid nodules, here, particularly follow Fig 1.

http://thyroidguidelines.net/revised/nodules

Plugging what you've said into that, you end at 'follow' not surgery.  Which means doing labs and an ultra sound every so often to see if it changes.  The other things I've read on profession literature is usually if they decide to remove a benign node, they only remove one side, not the whole thing, because it's safer and often the patent won't need meds.

One of the other things I've read recently for my own eduction is the chance a nodule is cancer doesn't depend on size very much leading to an impression that nodules are either cancer are they aren't cancer. And you're nodule isn't cancer.

The other thing to remember most thyroid cancer grows slowly and responds to treatment. You aren't in a race against life or death here.

Me I'd get a second or third opinion before going through with it.

PS: Don't let your doctor bully you into anything.
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Avatar_f_tn
Can you tell me more of what this means please ...
Smears and cell block show moderate background colloid from multiple
aspirate attempts. Scattered background macrophages are also identified.
Background lymphoid tissue is not appreciated. There are numerous
follicular epithelial cell groups present which are arranged in a
predominantly macrofollicular architecture. Prominent Hurthle cell change
is present, involving approximately 70% of the cell groups. Some of the
Hurthle cell groups exhibit mild to moderate anisonucleosis. No nuclear
features of papillary thyroid carcinoma are identified.
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Avatar_f_tn
I went for the Sondheim opinion like you suggested...
They ran blood tests. These were the results...


Thyroglobulin antibody screen : 57

Thyroglobulin tumor marker : 4.6

Tsh : 0.35

T4 : free : 1.00

T3 total : 100

Thyroperoxidase aby : 144.27


Combined with the above more specific findings of the fna
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Avatar_f_tn
.... With all this info...

What do you think? Cancer?

Shouldnt the tumor marker be 0?

As I mentioned I have the beta thalasemia trait as well.

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97953_tn?1193367871
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