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Suspicious for Follicullar Neoplasam
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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 for Follicullar Neoplasam

Hello everyone.   I am a 32 yo mother with two children.   About six months ago I noticed a knot just under my jaw bone which was hard and swollen.  I went to my doctor she said lets just watch it.  Well I work in the ultrasound department and one on the techs looked at the lymph node for me and suggested I get a actual order from my physician.   Turns out I have a nodule on both sides of my thyroid  both are over a cm and hypoechoic with incresed vascular flow.  The first FNA on the right nodule only, was hypocellular, my physician said lets follow it so I got a second opinon.  At which time they did a thyroid uptake scan and a secnd FNA.  They uptake scan showed both nodules in the left and right are cold.  The FNA on both sided shows supecious for follicular neoplasam.  So I am have a TT done in one week.   Everything I have read is very confusing, does anyone know anything about the spead of a follicular neplasam to the lymph nodes, and can it go anywhere else.  Any information would be great.  Thanks
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Follicular neoplasms carry a 20% risk of cancer.
Surgery is the most definitive approach, but sometimes molecular marker testing (for example, Afirma by Veracyte) can help avoid surgery if the ultrasound appearance and clinical history is low risk.  The Asuragen Test (Thyroid miRInform) is not likely to help avoid surgery in this situation.  Another option would be to have the slides sent for second opinion.  Hoewever, if these are large nodules that are growing, then surgery is best option.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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