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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Follicular cells on fna?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Follicular cells on fna?
by sheelstew, Oct 10, 2005 12:00AM
Hi Dr Mark
I asked your advice previously about a 3cm complex cyst, I have on my thyroid. My first FNA was insufficient, my repeat FNA (a core biopsy actually) shows a follicular lesion with cells that are hyperfollicular and microfollicular. I have been told there is a 5% chance it may be cancer and should therefore have surgery.(I am 44 years old and am told if cancerous I will have a much better prognosis at this age). Are there any centers that specialize in removing only what is necessary and retaining adequate thyroid tissue, so the patients do not have to take hormones? I have been told even if my nodule is benign, I will have a subtotal thyroidectomy and will need to take hormones.I really liked the surgeon and feel very confident of his abilities. I just can't get my head round having my normally functioning thyroid removed, if there is a 95% chance it is benign, and then having to take thyroid hormone, with the risk of osteoporosis and atrial fibrillation.How often do these things grow bigger even if benign? I would really appreciate your input Thanks
I asked your advice previously about a 3cm complex cyst, I have on my thyroid. My first FNA was insufficient, my repeat FNA (a core biopsy actually) shows a follicular lesion with cells that are hyperfollicular and microfollicular. I have been told there is a 5% chance it may be cancer and should therefore have surgery.(I am 44 years old and am told if cancerous I will have a much better prognosis at this age). Are there any centers that specialize in removing only what is necessary and retaining adequate thyroid tissue, so the patients do not have to take hormones? I have been told even if my nodule is benign, I will have a subtotal thyroidectomy and will need to take hormones.I really liked the surgeon and feel very confident of his abilities. I just can't get my head round having my normally functioning thyroid removed, if there is a 95% chance it is benign, and then having to take thyroid hormone, with the risk of osteoporosis and atrial fibrillation.How often do these things grow bigger even if benign? I would really appreciate your input Thanks
Doctor's Answer
by Mark Lupo, M.D., Oct 10, 2005 12:00AM
, Oct 10, 2005 12:00AM
The risk of osteoporosis and a-fib is low in pts on replacement if properly managed.
More importantly -- if there is a microfollicular pattern on core needle biopsy then there is about a 20% chance of cancer -- the literature reports 5-30% (or more) and in my experience it's about 20%. I would recommend taking the lobe that is involved out -- that leaves an 85+% chance of not needing thyroid hormone -- unless that shows cancer and then you need to have the rest of the thyroid out -- of course, that would mean lifelong thyroid hormone treatment...
Complex cysts may grow -- if it is 3cm and showing a microfollicular pattern then I would take it out.
More importantly -- if there is a microfollicular pattern on core needle biopsy then there is about a 20% chance of cancer -- the literature reports 5-30% (or more) and in my experience it's about 20%. I would recommend taking the lobe that is involved out -- that leaves an 85+% chance of not needing thyroid hormone -- unless that shows cancer and then you need to have the rest of the thyroid out -- of course, that would mean lifelong thyroid hormone treatment...
Complex cysts may grow -- if it is 3cm and showing a microfollicular pattern then I would take it out.
Member Comments (2)
by sadandscared, Oct 12, 2005 12:00AM
I am going through the same thing. I had my right lobe taken out and then the pathology reports came back showing a 2mm follicular cancer. Now I have to go for a second surgery. It stinks!! But docs reassure me that the hormone replacement therapy is not so bad. I know many women on synthroid and they report no side effects. You sound like you are in good hands and are proceeding in the right direction. Recovery from this surgery is not so bad. I ran 5 miles 8 days after my first surgery. I feel a bit tired, but I think it's more emotional. I am 34 and work as a therapist. The worst part is having to be out of work for 2 more weeks; I have my own practice...I don't get paid to be sick :( Good luck
