I found this in an archive entry on the doctors forum
Most follicular lesions (80%) are benign, but there is no test except surgery that can determine if it is malignant. The guidelines suggest obtaining an I-123 uptake and scan and if this is a "hot" nodule it can be watched. If it is NOT hot (ie either warm OR cold) -- then surgery.
My biopsy was atypical for follicular cancer but was actually benign. However, 2 small areas of pap cancer were found elsewhere in the gland .. very small and very encapsulated with no lymph node involvement. My 2 nodules they went in to remove turned out to be adenomas (or overgrowth of thyroid tissue).
My FNA report conclusion was "benign follicular clusters", I still had cancer...they just didn't get the right cells when they did the FNA biopsy. Follicular cells can be cancerous, or they can signal there are cancer cells present. Follicular cells that cluster is a bit more worrisome. Most follicular lesions are benign, but are 1 in 5 odds high enough for you to wait? What were your ultrasound results? How big is it? Does it have vascularity? What shape, round or irregular? All these factor in to a decision. If your nodules are large, vascular and irregular, and if they have calcifications, then your chances are a bit higher.
Heres a quandry.... Just had a hemithyroidectomy, the pathologist was unable to determine its significance during the surgery so they just took the 6cm nodule and right side of the thyroid out. The pathologist was still unsure after analyzing the tissue, so he sent it to a follicular neoplasm specialist in Italy. The verdict? He cant be sure either. He determined that its a follicular lesion that has many characteristics of cancer cells.
Do i have the 2nd half removed or wait and watch it?
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