FNA Results~Confused, Concerned

[JulieRF]

Hello,

Went to see my endo for the first time a few months ago. My TSH was 6.1 with the upper range being 4.5. My doctor said if we were going to treat for hypothyroid that we should make a real commitment and he put me on 100 levothyroxine. When I started taking the meds, I had a small bulge on the side of my neck and it had been there for quite sometime. Also, once I started taking the levo. my thyroid seemed to be causing pain. My endo agreed to look at it on ultrasound but said it appeared multinodular with no large or predominant nodules. He said he didn't see anything that he felt needed biopsy, etc.

Well, I went for a follow up visit recently and at that time, my thyroid was again having jabs of pain and to me it just felt a little bigger in my throat despite being on levo for over 3 months. He kind of sighed and said we'd take another look. He told me nothing looked different to him than the last time but since the right side was so much larger, he would go ahead and do a FNA and see what we got. He stressed that upon ultrasound, he really didn't see anything worrisome and he'd be floored if it came back cancerous. He told me he was doing it for my sake to calm my fears.

Well, I've just about had a nervous breakdown waiting for the results of this thing and after nearly a week of waiting, I called the office and they had the results but the doctor is out of the office until Wednesday (7/20) and no one would be able to analyze the findings or advise me as to what to do next.

So, I picked up the report today and this is what it said:

Right thyroid, fine needle aspiration:
- Adequate for evaluation
- Follicular lesion of undetermined significance

COMMENT: The aspirate is cellular with focal mild cellular atypia and overlapping patterns.

Clinical correlation and a repeat aspirate in appropriate interval (e.g. Three months) are suggested.

I don't know why, but I'm really scared. I know this does not say suspicious for malignancy or malignancy identified, but with it not being clear cut benign, I worry. Throw in the twinges of pain and I just about go through the roof with anxiety. I'm just not sure if I'm comfortable with the "wait and see" approach and then again, I don't want to go yanking out my thyroid that might be fully benign.

Anyone ever seen a report like this? Can anyone shed any light either way on why I should find comfort or be concerned with this report? What should my next step be?

I like my doctor and thank goodness he did the FNA but I feel like up till now, I've been driving this bus. I think he would have let me walk out of the office the other day with a "see you in 3 months" had I not brought up my thyroid again. I wish he would have done this 3 months ago.

Any comments, suggestions or support would be greatly appreciated!

[JulieRF]

Thank You! Your words are quite calming.

This is the extent of the description. I didn't leave anything out. My doctor did the ultrasound and he said the nodule was quite small. I want to say less or around 2 mm. He said the whole goiter had small nodules on it.

He didn't write up a full, formal report so I don't know any other details about vascularity or other characteristics. He was so non-plussed with the whole thing. I trust his expertise but I was really hoping for a clear "benign". I think I'll learn to be grateful for not getting a malignant result or even a suspicious.

[MANmom]

Does it have any characteristics listed such as solid, cystic, mixed, vascularity...anything you left out? How big is it?  Seems like you are fine for now, cancer doesn't usually cause pain, so that is not an indication of anything to worry about.  If it is cancer or happens to later turn into cancer, take heart; thyroid cancer is usually VERY slow growing and usually does not spread or metastisize.  Waiting a few months for another look will be fine.  Do you have any other problems?  Hashimotos? Graves?  Sounds like eventually you will lose at least the part with the nodule, it more than likely won't go away.  Don't worry too much (I know that is hard...I waited many years without an answer) but you are being treated in accordance with standard practice.