FNA results advice needed

[TXDiva]

Here are my thyroid biopsy results:

Follicular Epithelial Cells and Rare Hurthle Cells

Comments:
No definitive colloid is identified in this specimen. The cytologic differential diagnosis includes nodular goiter and follicular neoplasm. Nodular goiter is favored somewhat, but clinical correlation is also needed.


Nurse Assistant at Endo discussed results at follow-up visit following biopsy. She said no cancer so nothing to worry about...re-check via ultrasound in one year. I left glad no malignancy was found but troubled that I didn't get to consult with Endo himself. After researching results on internet, discovered that possibly the only way to get definitive "begin vs. malignant" diagnosis is surgical removed of nodule. Is this true?  If so, why didn't Endo suggest that? Should I take results to another Endo for second opinion?

Nodule is 2.3 cm, also have second nodule on other lobe .86 cm.
2.3 nodule is vascular.
I was exposed to xray radiation weekly for a period of one year as an infant because of TB.
Thyroid levels have always showed normal on each blood test. Numerous symptoms is what caused discovery of nodules to begin with.

I just want to make sure observation is the right thing to do. I'd rather not have surgery unless absolutely necessary though.

Any insight is appreciated.

[TXDiva]

Thought you guys would want to see Dr. Lupo's response as well....

by Mark Lupo, M.D.
Would have the slides sent to an expert for a better reading in order to categorize this as either benign or indeterminate for follicular neoplasm --- the report should not say it could be either!  Baloch at U Penn is very good with this or Hopkins, Mayo, Harvard --- but a second opinion is needed.


Does anyone know if I can personally request (directly to the path lab) that the slides be sent to another expert or does a doctor have to do this?
How long will the slides be in the current lab before they dispose of them?

[TXDiva]

Thanks 898_1 and blsdnsvd for your comments!  I'm in the process of getting in to see another Endo for a second opinion. I talked with my GP today and he agreed that the pathology report sounded very sketchy to him even.

blsdnsvd, were your nodules malignant?

[blsdnsvd]

Honestly, I'd get a 2nd and possibly 3rd opinion on those results...because mine were very similiar and all of my opinions suggested total removal of my thyroid..no waiting! My thyroid labs were all normal as well and my surgeon explained that as long as the thyroid is functioning with the nodules, the results will be normal ....  

[898_1]

If Hurtle cells are forming sheets or clusters then it will for sure mean the neoplasm.
Rare Hurtle cells can be found among patients with Hashimoto's thyroiditis.
Due to the lack of colloid in the specimen, you definitely need a second opinion from the different cytologist; your present report sounds very sketchy. If neoplasm will be favored after second opinion, the molecular testing can be used to determine odds of malignancy.