Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Suspicious Thyroid Nodule
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Suspicious Thyroid Nodule

I am getting ready to go through my second biopsy of a solitary 2.4 cm thyroid nodule on my left lobe. My nodule is hypo echoic, has ill defined borders (no halo), micro-calcification, and inter vascularity. My endo thinks the first biopsy may have missed the cancer. Whenever I read about these characteristics, I read that individually none of them automatically means I have cancer, but I never read anything about having all of these characteristics together. She says that when they do these FNA's, they take such a small portion and its actually easier to miss than you would think. Originally, the results said my nodule was benign and consistent with lymphocytic thyroiditis, but she is very concerned and isn't convinced that is the case. She is bringing in another doctor to assist with the biopsy the 2nd time. If it missed the first time, could it miss the second? How will I ever know for sure? My nodule is apparently really suspicious and I just don't know what to do to put my mind at ease.
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A repeat biopsy of a suspicious nodule is a good idea if the first biopsy was benign.  2 benign biopsies carry a high probability of a benign process but the nodule would need to be monitored for growth and possibly removed if there is significant growth.  Properly performed fine-needle aspiration biopsies carry a very accurate assessment of thyroid nodules.  If there is background thyroiditis, make sure this is correlated with thyroid antibodies.  
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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