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553113 tn?1236177211

Results on FNA

I was wondering if someone could give me advice.  It was discovered by a CT back in July that I had a thyroid nodule on the left and the right side.  They both measure about 1.4.  I had my first FNA and the right side came back benign, but the left side should microfollicles and could not rule out follicular neoplasm.  My doctor told me at the time that we could surgically remove it or wait four months and do another FNA.  I decided to have another FNA.  During this time I did a lot of research and it seems to me that they recommend surgically removing it because it has a 10-20% chance of being cancer.  So, I just got the results of my 2nd FNA yesterday and it still shows follicular neoplasm.  My doctor told me over the phone that it wasn't anything to worry about and unless it really starts growing that even if it was cancer it wouldn't hurt me. I tried telling him that it still worries me and that I read that it should be removed. He then told me to make an appointment to discuss this.  So,  my question is-  Is it ok to just wait and see or should I get a second opinion.  He made it sound like unless I am losing sleep over this, I should just leave it alone.  I don't want to appear like I am a hypochondriac, but I am worried about it.  Anyone with advice, I would be really grateful to hear it
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Avatar universal
my name is Azam from Pakistan and i also have same case like jakson and my doctors also recomended surgery so i am going hospital on tuesday 8th dec 2009 for surgery pl pray for me after come back I explain my feelings etc
follicular neoplasm case help me to take descesion and now i feel that i am lucky because ALLAH ALMIGHTY give me chance to take good advices from people
regards
Azam
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Avatar universal
I know this is a late comment, my FNA also came back follicular neoplasm. Also the nodule grew1/2 the size in 4 years. I had a TT March 13 09 and I am so  glad I did. The Dr said that the thyroid wrapped itself around my trachea and a 1 hour surgery turned into a 2 hour surgery. The ultrasound did not show the extent of the thyroid mass. I would advise you get several opinions. I got 2 and they both agreed with surgery.
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553113 tn?1236177211
Thanks so much for your advice.  I have my appointment on Thursday.  I am glad to have some other opinions.  I will let you know what I find out.  Lynn,  thanks so much for spending time to answer my questions.  You have been a great help.
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Avatar universal

That's interesting that your FNA was positive but the final biopsy negative.  What a relief though!
My doctor told me that removing it was the best thing in my case as this type of nodule just continues to grow.  
I also read that the only way to diagnose the follicular adenoma that I had is by removal as FNA is not diagnostic.
jackson3:
I don't know what they do to treat thyroiditis....I didn't know that I had that until the final pathology report.  As for the FNA I don't have it at the moment but it wasn't definitive and mentioned the possibility of both papillary cancer and follicular neoplasm.
Like you, I didn't know about the nodule until it was found on another scan.  Mine was from an MRI of my cervical spine that was done because of disc degeneration and disc protrusions.
Good luck with your doctors appointment next week....be sure to write down any questions you think of so you don't forget them when you have your appointment!
take care,
Lynn:)
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Avatar universal
I had a FNA in March this year. My Endo said any nodule near 1cm should be surgically removed and biopsied.
She called me at work to tell me the FNA was positive for cancer and I would have to have my thyroid gland removed and follow up with the radioactive iodine treatment. (Scared the s**t out of me!)  I wanted it out ASAP.
Turns out, FNA's are not a definitive diagnosis...the biopsy's from my removed gland were negative.  I insisted the biopsy slides be sent for a second opinion for my satisfaction...it too was negative.  
Definitely, a second opinion is what I would do.  If it is cancer, I want it OUT!

Cindy
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553113 tn?1236177211
Yea!! I am glad that you got good news yesterday.  I bet you felt a lot better.  So, with the thyroiditis, is there anything they do for that.  Do they just test your levels?  Isn't it weird how your thyroid can cause do many problems.  I keep thinking that if I wouldn't have had a CT scan, I wouldn't even know that I had these problems.  I am really happy to hear that your incision looks really good.  I figure if I have this surgery and I don't need to be put on meds, then the only thing that is really affected is the scar.  If the scar doesn't look too bad then I wouldn't be mad at all about having the surgery.  I am really grateful for you keeping me informed on all of this.  I have my doctor's appointment next Thursday.  I think I will feel much better when I know what the next step is going to be.  When you had your FNA what did it say?  Did it mention microfollicles?  Mine had that and that is why it said it couldn't rule out a follicular neoplasm.  I think I am ready to just have it out.  If it continues to grow like your doctor says, then why put off the inevitable?  Thanks so much for everything.  I hope you have a great Thanksgiving.  I am working today, but have the next three days off.  I am a nurse, so we don't get the luxury of having the holidays off.  There are always sick people!!
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Avatar universal
I had my followup appointment yesterday and the stitches are out!  More importantly the final path results confirmed that it was a benign follicular adenoma.  My doctor said that this is not the most common type of benign thyroid tumor but one of the more troublesome ones since they tend to keep growing.  This made me feel like removing it was the best choice.  He said it was about 2 cm.....Ultrasound listed it to be about 1 cm a couple of months ago.
He also said there was some thyroiditis (which initial operative path did not show).  I will go back for followup in two more months to test levels to be sure right lobe is working properly.
And the incision actually looks MUCH better than I expected!  The doctor had told me prior to surgery that they use plastic surgery techniques and looking at it I believe him.  There is swelling of the area so it is a little lumpy but the incisino is VERY narrow and I can see it will be difficult to see when the swelling goes down....much less in a few months.  I have to wait 9 more days to put anything on it, but he said I could use vitamin E oil or whatever I want at that time.
Best of luck with your appointment and please keep me posted.
I'm sure everything will work out well for you too!!!
Oh and my doctor also said that part of my laryngitis was just from being sick....so again it is hard for me to tell what is from surgery and what is just from being sick.
take care and keep in touch.
Lynn:)
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553113 tn?1236177211
So, how does your incision look now that you got your stitches out?  I hope you tolerated it well.
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553113 tn?1236177211
I am glad things went well today.  Thank you so much for the details after the surgery. Those are the things that you don't hear much about.  I am glad to hear that your incision is healing so nicely.  If I have mine done, I hope it goes as well as yours.  I did hear about the voice problems after the surgery.  I can't believe you still can't talk a week later.  Hopefully that gets better soon.  

I don't know if I am having thyroid symptoms.  I do know that I have hot flashes a lot and I am only 31.  I also feel anxious and jittery sometimes.  My doctor only tested my TSH and it was 0.4, so on the very low end of normal.  Of course he said it was normal.  I am still wondering if he will do the surgery or not.  The first FNA I had that came back as follicular neoplasm I decided to wait and repeat it.  I didn't enjoy the wait and was very anxious on what it would say this time.  Now that it is abnormal again I would rather just take it out and move on.  I wonder why my doctor seemed like he was leaning more towards waiting again when he gave me the option of surgery the first time.  I just want to make sure that I am making the right decision. When you have a doctor that is making it sound like it is fine to wait and you feel like doing the surgery it makes you feel as if you are overreacting.  It is reassuring to see that others have this surgery for the same reasons without any regrets.  

Thanks for all of you stories.  It really makes me feel as if the surgery wouldn't be too bad and I wouldn't be overreacting to a follicular neoplasm.  Anything you want to add or would like to talk about is very much appreciated.  
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Avatar universal
It wasn't bad at all.....other than the massive pile of work! lol  I am still congested (most likely just from chest cold) but I actually worked 9 hours today!  I have to leave work early tomorrow to get stitches out so I wanted to get more done today:)  
I am surprised at how good the incision looks.  There are steristrips on top of the stitches but I can see through it fairly well.  My co-worker said it looks a lot better than her friend when hers was recently done, so I guess that means I had a good doctor:)  I plan to ask him tomorrow about a product called mepiform to help the scar to go away.  It is a self adhesive silicone dressing for scar care that is supposed to help it to be less obvious.  I plan to start using it as soon as he gives me his approval....just hoping it will go away sooner rather than later.  I was told by a friend of a friend that it can take several months but eventually isn't noticeable.
I am still glad that I had the surgery....looking back I think I was having symptoms related to this nodule that were 'written off' as peri-menopausal symptoms instead.  
As for the drainage tube.....they didn't even have to stitch up the skin when they removed it just prior to my leaving hospital.  It just left a tiny hole which healed on it's own just fine.  My surgeon did tell me they use plastic surgery techniques when stitching and that part of the reason to take it easy is for it to heal well.  I didn't expect it to be so low on my neck though.
The most annoying thing to me is that my voice is not close to normal.  If I whisper I sound normal (for a whisper), but if I try to talk it goes up and down.  If I try to raise my voice....forget it!  My voice is all over the place and I end up sounding like Mickey Mouse!

Gargling with salt water was helpful for the sore throat....and at the hospital I ordered chicken broth as that helped too.  Warm tea was also nice.
It does feel weird to swallow at times too but that doesn't bother me much.
I will let you know how my appointment goes tomorrow.

Something else to keep in mind.....are you having any thyroid symptoms?  There are lots of different symptoms that are related to the thyroid that you might not even think about.  My nodule was found by accident although looking back there were quite a few different symptoms over the past couple of years that could be related to this.  
Thyroid bloodwork was done more than once in the past two years and were always within normal range so I guess my PCP didn't corelate the symptoms.

Well, best of luck to you and please do keep in touch!  ....and don't worry too much....most thyroid nodules are NOT cancer.

Lynn:)
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553113 tn?1236177211
How was your first day back at work?  Did you have your energy back?  I hope you get good news tomorrow.  You will have to let me know how it went.  That ***** that you got sick on top of your surgery.  Are you feeling better now?  I didn't realize that they put a drainage tube in after surgery.  How is your incision site?  Does it look pretty bad or better than you thought?  The scar is the part that I am worried about.  Are you still glad that you had the surgery?  I am still wondering what my doctor is going to say I should do.   Thanks for replying and answering my questions.  I hope you are doing great and your tests are negative.  Let me know how things turn out.  

Jackie
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Avatar universal
I am glad I had the surgery although I am still waiting for final pathology which I hope to find out tomorrow when I have stitches removed.  The surgery wasn't really that bad....I it hard for me to judge whether the sore throat I experienced after surgery was just from the surgery or from getting sick.  I felt like I had strep throat for a few days but the pain is minor now.  My doctor told me to take off a week of work and I am about to go back this morning.  I had my surgery a week ago today.  They had a drainage tube in my neck to drain fluid more quickly.  My doctors requirement was that if you drained more than 10 ml of fluid in an 8 hour period you had to stay in the hospital.  I actually drained exactly 10 ml by Tuesday afternoon, so I was allowed to go home that night.  
My family had been sick prior to my surgery and I started feeling like I was getting a chest cold the morning of.....but not wanting it to be rescheduled I didn't tell anyone at the hospital.  That is what made it hard for me to figure out what was from the surgery and what was from being sick.....I had a lot of chest congestion which I believe was not related to the surgery.  They said that a sore throat is to be expected due to the tube as well as just the fact that they are manipulating the muscles in the neck when they do the surgery.  The sore throat was the worst part for me.....the neck just feels like sore muscles and really isn't that bad.
My surgery was scheduled I believe almost 2 months ago.  My understanding is that even if it was thyroid cancer it is generally one of the least dangerous cancers to have.
Best of luck to you and try not to worry too much.....thyroid cancer really is one of the 'better' cancers to have if you have to have any type of cancer.
take care and keep in touch!
Lynn:)
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553113 tn?1236177211
Thank you so much for your story.  It was nice to hear from someone with a similar situation. I really hope that everything turns out great for you. I am leaning towards the surgery also.  I don't know why I would wait if there was a chance of cancer.  I don't see my doctor to discuss this for another 2 weeks.  I am kind of upset with him that he tells me the news over the phone, but then makes me wait to see him in person to figure out our plan.  I am going to tell him that I really just want it removed.  Are you glad that you had it done even if it is negative?  How was the surgery?  Are you in a lot of pain?  How long do you need to take off of work?  I have so many questions.  If you are feeling up to it,  I would love to hear from you again.  I hope you are feeling ok and I will be thinking about you.
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Avatar universal
I too had inconclusive FNA.  Mine was a 1 cm nodule in left lobe of thyroid.  The ENT I saw (who also specializes in thyroid/neck surgery) gave me both options too, but when I  asked what he would do if it were his family member he told me that he would remove it.  My FNA had characteristics of papillary cancer but follicular neoplasm as a possibility as well.  I just had my left lobe removed on Monday and at that time they felt it was a follicular adenoma (benign).  I will find out on Tuesday when I see him to have stitches removed as the pathology results should be back by then.
Don't let anyone make you feel like you are a hypchondriac....being proactive with your health is very important!
Best of luck to you!
Lynn:)
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553113 tn?1236177211
Thanks for commenting.  I have an appointment with the ENT in 2 weeks to discuss this.  I will ask him about the core biopsy.  He didn't even bring that up as an option.  I was thinking that an endocrinologist might be more informed on these things.  Have you heard of anyone else that had a follicular neoplasm and what they ended up doing?
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553113 tn?1236177211
Thank you so much for taking time to give me feedback.  I made an appointment with an endocrinologist in January for a second opinion.  I just want to make sure that the first doctor is giving me the best option.  It would be nice if it was safe to wait, I just wanted to make sure.  Thanks again.
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168348 tn?1379357075
I would go with a core biopsy. My orig. script read the regular FNA way and/or core biopsy if necessary.

Core is more thorough in cases like yours.

PLS stick around and keep us posted!!!

WELCOME to the COMMUNITY!

C~
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314557 tn?1232926664
FNA is not 100% reliable. My advice to you is if you are not satisfied, get another opinion or as 898 said insist on a core biopsy which involves a larger tissue sample which may be more reliable. It is hard to predict how quickly or even if this could become a problem but I would go with my gut and it sounds like your gut is telling you to pursue this. Papillary cancer is very treatable but can still invade the vascular system in the neck if it goes unchecked and that is the "good" cancer. You are clearly staying on top of it which is a very good thing. I had a dramatic change in 1 year and went from 4 nodules to 13, the FNA was positive, the frozen section during surgery was negative, the full pathology report showed 3 cancerous nodules and 1 lymph node. If you don't think your doctor is taking this seriously, find another doctor as a matter of fact it might be best to get a second opinion anyway and then decide who you feel more comfortable with. You may be able to wait and see for awhile, but I guess I would suggest getting that from another source and only if you are comfortable. You are not being a hypochondriac you are taking a proactive approach to your health and that is very good thing. Good luck to you and keep us posted.
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Avatar universal
898
in this case CORE biopsy may give better information as cell arrangement in the tissue can better show the difference between benign and malicgant nodule
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