Aa
pathology report - does it seem questionable??
hi,
I've posted a few posts in the last days about my having an appt with ENT to review my path report. My primary (who had found the nodules on a chest ultra, ordered the biopsy, then called me with the great news it was benign) just wanted me to see the specialist to see if he thought this 4cm nodule should be shrunk, etc....)
So, I was surprised when the ENT dr. almost immediately decided I had hashimotos (no bloodwork at all at that point), and talked about the different cancers, that there can be false negatives, etc... and I believe he was talking about medullary because that is the only one you would need to have your family tested for, if you have it.
Anyway..............I just got the copy of the path report I requested............I know I'm not a dr........but I dont' really
see what stands out to make him think my results are NOT benign, or indicate medullary???
If anyone has any thoughts please let me know...................maybe he just says that to everyone?? But then, he did have me take a bloodtest for calcitonin..........
"Many groups of benign follicular cells arranged in a predominantly macrofollicular pattern with fragments of colloid material present. Rare groups of huertle cells also present. Red blood cells, neutrophils and lymphocytes are present in the background. One liquid based thin layer cytologic slide is prepared for microscopic examination"
Diagnosis: Left thyroid fine needle aspiration for cytology: Negative for Malignancy
I am SOOOOOOOOOOOOOO scared with all the reading I've been doing on that type of cancer.............WHY is that what he's thinking? I would assume even if something on the ultrasound films were indicative..............the MD who initially viewed my films, and made the ultrasound report would have thought so too????
thanks everyone, for your guidance
I've posted a few posts in the last days about my having an appt with ENT to review my path report. My primary (who had found the nodules on a chest ultra, ordered the biopsy, then called me with the great news it was benign) just wanted me to see the specialist to see if he thought this 4cm nodule should be shrunk, etc....)
So, I was surprised when the ENT dr. almost immediately decided I had hashimotos (no bloodwork at all at that point), and talked about the different cancers, that there can be false negatives, etc... and I believe he was talking about medullary because that is the only one you would need to have your family tested for, if you have it.
Anyway..............I just got the copy of the path report I requested............I know I'm not a dr........but I dont' really
see what stands out to make him think my results are NOT benign, or indicate medullary???
If anyone has any thoughts please let me know...................maybe he just says that to everyone?? But then, he did have me take a bloodtest for calcitonin..........
"Many groups of benign follicular cells arranged in a predominantly macrofollicular pattern with fragments of colloid material present. Rare groups of huertle cells also present. Red blood cells, neutrophils and lymphocytes are present in the background. One liquid based thin layer cytologic slide is prepared for microscopic examination"
Diagnosis: Left thyroid fine needle aspiration for cytology: Negative for Malignancy
I am SOOOOOOOOOOOOOO scared with all the reading I've been doing on that type of cancer.............WHY is that what he's thinking? I would assume even if something on the ultrasound films were indicative..............the MD who initially viewed my films, and made the ultrasound report would have thought so too????
thanks everyone, for your guidance
hey,
thanks for your input!! I definately want to have the whole thyroid out, so I've pretty much made up my mind about that.........right now I"m just sweating getting the bloodwork, and I'm nervous because it is large, and I'm 48, which is just over the 45 age when they say it can be worse. so, praying the biopsy was correct (negative), but I, too, opt to be better safe than sorry, and get it out!
thanks for your input!! I definately want to have the whole thyroid out, so I've pretty much made up my mind about that.........right now I"m just sweating getting the bloodwork, and I'm nervous because it is large, and I'm 48, which is just over the 45 age when they say it can be worse. so, praying the biopsy was correct (negative), but I, too, opt to be better safe than sorry, and get it out!
I had a total thyroidectomy on September 2nd. My biopsy in August showed Follicular cells, but could not be determined benign or malignant. My endo said take the left lobe out... where the complex nodule was. I saw an ENT surgeon, who said I didn't have to have the surgery, it was my choice. I decided to have the surgery, and opted to have a total thyroidectomy. There is no history of thyroid cancer in my family, although thyroid disease is present. A week after the surgery, I was told I had follicular thyroid cancer. My nodule was only 1.1 cm, smaller than what the original ultrasound showed. I am also fairly young to have follicular, as it is more common in women around 40. (I am 26). HOWEVER... I took my chances on being a little more aggressive, even though I knew I would need medicine the rest of my life, and I became lucky. My cancer was only stage 1, and all I need is a dose of RAI and I will be good to go. My point is, I went with my gut instinct, and no matter how unlikely the cancer result was going to be, I didn't want to risk it. Medullary is treatable, especially if found early enough. If you are unsure about what your dr. is telling you, get a second opinion. 4 cm is very large, and maybe for that reason alone you might want to consider having it removed. FNA's are not always accurate, unfortunately, however, sometimes they are! what does your gut tell you to do??
Hi,
I had a goiter for several years (2004) before it's removal in 2009. It was a watch and see approach. After the initial fine needle biopsy to rule out cancer, I was told well it is so large you can't biopsy everything. Great. Why did I really have it done in the first place! It came back benign. So, I didn't have surgery back then. I took levoxyl for hypothyroidism and to keep goiter down. It wouldn't stay down and I noticed it got larger in 2008 (another biopsy) which again showed benign multinodular goiter and Hashimoto diagnosis made then. No antibodies test done, the endocrinologist just said it was Hashimoto's. I suppose based it on the huge goiter in my neck. It was playing around with right side growing/left side growing so a fine needle biopsy did not help then since it came back benign. "nodule versus follicular neoplasm" needed to be evaluated again.
Finally, a carotid ultrasound by Primary doc because of dizziness, showed goiter enlarged. Went back to endo, got a surgery referral, had TT (Hashimoto's was going to destroy it anyway) in July 09 and found papillary carcinoma T2.
It seems that cancer cannot definitely be ruled out until the actual tissue is biopsied and not just a few cells. Oftentimes they get blood or other material. A multinodular goiter is just too big to get all sampled. Upon a TT then it can be sure. Now, if it were a single nodule, I think they have a better idea with fna. Check on the huerthle cells part. I have seen that before but don't know what it means. That seems to be different.
In my case, I did not have breathing difficulty or swallowing issues which is really bizarre. In those cases it is clear to have it removed if the size of it is an issue. With meds, if it doesn't remain the same or shrink, then it is time to look at why. A friend of mine's goiter went down with medication. Mine obviously didn't. People live with goiter all the time, just be aware if it continues to enlarge that there is a problem. Also, monitor your own goiter. There were a couple of years there that I was confident of the benign nature of the last fnas but I should have been doing my own neck checks to be sure that goiter was not enlarging or insist on another ultrasound. Other things became a focus rather than my health. Keep on top of it.
I had a goiter for several years (2004) before it's removal in 2009. It was a watch and see approach. After the initial fine needle biopsy to rule out cancer, I was told well it is so large you can't biopsy everything. Great. Why did I really have it done in the first place! It came back benign. So, I didn't have surgery back then. I took levoxyl for hypothyroidism and to keep goiter down. It wouldn't stay down and I noticed it got larger in 2008 (another biopsy) which again showed benign multinodular goiter and Hashimoto diagnosis made then. No antibodies test done, the endocrinologist just said it was Hashimoto's. I suppose based it on the huge goiter in my neck. It was playing around with right side growing/left side growing so a fine needle biopsy did not help then since it came back benign. "nodule versus follicular neoplasm" needed to be evaluated again.
Finally, a carotid ultrasound by Primary doc because of dizziness, showed goiter enlarged. Went back to endo, got a surgery referral, had TT (Hashimoto's was going to destroy it anyway) in July 09 and found papillary carcinoma T2.
It seems that cancer cannot definitely be ruled out until the actual tissue is biopsied and not just a few cells. Oftentimes they get blood or other material. A multinodular goiter is just too big to get all sampled. Upon a TT then it can be sure. Now, if it were a single nodule, I think they have a better idea with fna. Check on the huerthle cells part. I have seen that before but don't know what it means. That seems to be different.
In my case, I did not have breathing difficulty or swallowing issues which is really bizarre. In those cases it is clear to have it removed if the size of it is an issue. With meds, if it doesn't remain the same or shrink, then it is time to look at why. A friend of mine's goiter went down with medication. Mine obviously didn't. People live with goiter all the time, just be aware if it continues to enlarge that there is a problem. Also, monitor your own goiter. There were a couple of years there that I was confident of the benign nature of the last fnas but I should have been doing my own neck checks to be sure that goiter was not enlarging or insist on another ultrasound. Other things became a focus rather than my health. Keep on top of it.
I went to ENT specialist for overactive thyroid. Did a ultra sound found 3 masses. The biggest one is 2.3 CM. He did autopsy right there. He took 3 samples of the biggest mass. I have to wait a WEEK for results. It is driving me crazy.
I hope this forum helps you.
I had thyroid cancer last year. My FNA was negative. The left side of my thyroid was growing at a good pace and was beginning to interfere with eating, swallowing, etc. My ENT suggested surgery due to the size alone but only to remove the left side. We discussed the pros and cons and eventually opted to do a total thyroidectomy as I did not want to come back to have the other side removed. My gut just kept telling me to do it. Well, my gut was right! the cancer was not on the side that was growing but was on the side considered "normal."
Ask questions! If your ENT says Hashi's then ask why, ask why the sudden jump to cancer. Also, Medullary is a serious cancer but Anaplastic is by far the worst - it is terminal just because you have it. Medullary is not a death sentence - my son is dating a girl whose father had it and is healthy now - she and her siblings are tested every 6 months for markers.
Ask for answers and if your doc doesn't give them - ask another doctor. MAKE SURE YOU SEE AN ENDOCRINOLOGIST BEFORE MAKING ANY DECISIONS! When you have all their suggestions, then you can make your choice.
I wish you the best of luck.
I had thyroid cancer last year. My FNA was negative. The left side of my thyroid was growing at a good pace and was beginning to interfere with eating, swallowing, etc. My ENT suggested surgery due to the size alone but only to remove the left side. We discussed the pros and cons and eventually opted to do a total thyroidectomy as I did not want to come back to have the other side removed. My gut just kept telling me to do it. Well, my gut was right! the cancer was not on the side that was growing but was on the side considered "normal."
Ask questions! If your ENT says Hashi's then ask why, ask why the sudden jump to cancer. Also, Medullary is a serious cancer but Anaplastic is by far the worst - it is terminal just because you have it. Medullary is not a death sentence - my son is dating a girl whose father had it and is healthy now - she and her siblings are tested every 6 months for markers.
Ask for answers and if your doc doesn't give them - ask another doctor. MAKE SURE YOU SEE AN ENDOCRINOLOGIST BEFORE MAKING ANY DECISIONS! When you have all their suggestions, then you can make your choice.
I wish you the best of luck.
thats just how I would describe the biopsy, not painful, but..........definately uncomfortable with the jabbing and poking around...........repeatedly!! I agree if we can't breath a sigh of relief with a negative biopsy, what is the point. I would feel totally better just taking the thyroid out........so we 'll see what he says regarding my bloodwork, etc.. when I see him the same week you meet with your dr. Mine is an ENT specialist.........is that the same as an endo surgeon? My dr. does do the thyroid surgeries........though I plan to ask how many he does, etc..... I want a specialist if I have to have surgery!!
Biopsy went okay - not the best experience in the world. Not so painfull as uncomfortable. Report yesterday said that if aspirates reveal only blood rather than cellular material a follow-up ultrasound in three to six months is suggested. But was also told yesterday it depends if they got to the cancer cells if there is any. Which left me sort of confused - why then bother with a biopsy if thy cannot be 100% sure. I presume its better than nothing.
I will only have my results by tomorrow the earliest.
I first got diagnosed when my second child was about 9 months - i went to see a Post natal depression psychiatrist thinking i had post natal depression. Had no hard feelings towards my little one but i could just not cope with anything, always tired, my husband would find me sitting on the kitchen floor crying to tired to even pack the stupid dishwasher - laugh at it now thinking about it but it was not funny at the time.
The psyc send me to a Dr (GP) to get a script for antidepressions but she first wanted to test my Thyroid. Thanks to her i got diagnosed. TSH levels were high in the 90ties and thyroid antibodies was present. I did not have a goiter or any other symptoms besides the extreme tiredness, dry skin, loosing hair and not coping.
Now 3 years later suddenly it's another story. I fell pregnant with our third child - not planned - was scared out of my mind worrying about what my Hashimoto's would do to my unborn child - was seen by 'n endocrinologist who kept my TSH between 1-2 throughout the pregnancy and increased my thyroxine as needed. All went very well with my Hashimoto's but then i got Gestational Diabetes for the first time and ended up being on insulin as well. My baby boy was born at 38 weeks - by c-section and is a healthy almost 8 month old.
With him he was seen by 'n peadiatric endocrinlogist at 8 day's and 3 weeks and both times blood tests was done on him looking for thyroid antibodies and normal TSH, T3 T4 bloodwork. They were worried that some of my antibodies might have passed through the placenta to him and cause problems to him. But all turned out well - These test were done so young because if they can find the problems before 6 weeks of age - permanent mental damage and mental development damage can be prevented by starting on medication soon.
He is perfect in every way and very healty. I was told that my daughter will have a higher chance in her 20ties to have thyroid related problems. But im always worried about my two boy's as well.
I've been reading alot lately and last night.
Things that makes me concern for cancer is the fact that:
hashimoto's has a slight higer chance for cancer growth's
Sudden fluctuations of normal TSH, T3 T4 levels
Hoarsness
Pain in the neck
One nodule solid or complex (semicystic solid nodule)
Thyroid scan (radioactive iodine) show "cold" nodule
what makes me worried is if the pathology result comes back "no cancer" i will be happy but i still have all the above symptoms and where does that leave me - i will still be worried.
Im seing a endo surgeon the 8th of October and hope he will be able to do all the right tests and make sure all is well - personally i would just have everything removed. Having Hashimoto's makes us more prone to nodule growth and who knows it might be a year 5 years or 10 before cancer does pop up.
Maybe im just to stressed out but i don't wan to be a time bom.
All the best with your results and outcome keep in touch
I will only have my results by tomorrow the earliest.
I first got diagnosed when my second child was about 9 months - i went to see a Post natal depression psychiatrist thinking i had post natal depression. Had no hard feelings towards my little one but i could just not cope with anything, always tired, my husband would find me sitting on the kitchen floor crying to tired to even pack the stupid dishwasher - laugh at it now thinking about it but it was not funny at the time.
The psyc send me to a Dr (GP) to get a script for antidepressions but she first wanted to test my Thyroid. Thanks to her i got diagnosed. TSH levels were high in the 90ties and thyroid antibodies was present. I did not have a goiter or any other symptoms besides the extreme tiredness, dry skin, loosing hair and not coping.
Now 3 years later suddenly it's another story. I fell pregnant with our third child - not planned - was scared out of my mind worrying about what my Hashimoto's would do to my unborn child - was seen by 'n endocrinologist who kept my TSH between 1-2 throughout the pregnancy and increased my thyroxine as needed. All went very well with my Hashimoto's but then i got Gestational Diabetes for the first time and ended up being on insulin as well. My baby boy was born at 38 weeks - by c-section and is a healthy almost 8 month old.
With him he was seen by 'n peadiatric endocrinlogist at 8 day's and 3 weeks and both times blood tests was done on him looking for thyroid antibodies and normal TSH, T3 T4 bloodwork. They were worried that some of my antibodies might have passed through the placenta to him and cause problems to him. But all turned out well - These test were done so young because if they can find the problems before 6 weeks of age - permanent mental damage and mental development damage can be prevented by starting on medication soon.
He is perfect in every way and very healty. I was told that my daughter will have a higher chance in her 20ties to have thyroid related problems. But im always worried about my two boy's as well.
I've been reading alot lately and last night.
Things that makes me concern for cancer is the fact that:
hashimoto's has a slight higer chance for cancer growth's
Sudden fluctuations of normal TSH, T3 T4 levels
Hoarsness
Pain in the neck
One nodule solid or complex (semicystic solid nodule)
Thyroid scan (radioactive iodine) show "cold" nodule
what makes me worried is if the pathology result comes back "no cancer" i will be happy but i still have all the above symptoms and where does that leave me - i will still be worried.
Im seing a endo surgeon the 8th of October and hope he will be able to do all the right tests and make sure all is well - personally i would just have everything removed. Having Hashimoto's makes us more prone to nodule growth and who knows it might be a year 5 years or 10 before cancer does pop up.
Maybe im just to stressed out but i don't wan to be a time bom.
All the best with your results and outcome keep in touch
how did the biopsy go? geez, you were told even before the biopsy that a negative result might not really mean that? what should we hope for then, you know? how did you initially become diagnosed with hashimoto's? Have they talked about testing your children for the hashimotos'?
I am going for my biopsy today - was also told that even if the result comes back negative it does not mean it is negative - it just depends if they actually got the right cells to test and they might miss the cancer cells altogether - that's why depending on blood works, scans ect your surgeon might still decide to remove the nodule all together for furher testing.
I know its stressful but be glad that you have a Dr that wants to test everything and make 100% sure of the outcome. The first Dr i went to see after my ultrasound - i have a semi solid nodule 2.5 x 1.8 x 2.2 cm and became suddenly hypo, have hashimoto's, lump in throat and hoarse voice - he felt it's just Hashimoto's related - inflamation and if it makes me feel beter he will refer me to see a surgeon
I went back to my normal GP and he was horrified that no further action was taken - ive been for the radioactive iodine test which showed up as a "cold" nodule and now going for biopsy and in 2 weeks time will see the surgeon for further treatment.
Let your Dr rather look at all posibilities and stay clear from Dr's that thinks its nothing until they have looked at all posibilities and made sure its clear.
All the best of luck
I know its stressful but be glad that you have a Dr that wants to test everything and make 100% sure of the outcome. The first Dr i went to see after my ultrasound - i have a semi solid nodule 2.5 x 1.8 x 2.2 cm and became suddenly hypo, have hashimoto's, lump in throat and hoarse voice - he felt it's just Hashimoto's related - inflamation and if it makes me feel beter he will refer me to see a surgeon
I went back to my normal GP and he was horrified that no further action was taken - ive been for the radioactive iodine test which showed up as a "cold" nodule and now going for biopsy and in 2 weeks time will see the surgeon for further treatment.
Let your Dr rather look at all posibilities and stay clear from Dr's that thinks its nothing until they have looked at all posibilities and made sure its clear.
All the best of luck
thanks for replying:)
I believe my thyoid will be removed, I'm just on pins and needles waiting for my next appt. Today I started feeling a sore throat when I swallow...on the side where the large nodule is...........I think I"m going to call the office, ask if my bloodwork is in yet, and if so, ask if I could have the dr. give me a call................
I believe my thyoid will be removed, I'm just on pins and needles waiting for my next appt. Today I started feeling a sore throat when I swallow...on the side where the large nodule is...........I think I"m going to call the office, ask if my bloodwork is in yet, and if so, ask if I could have the dr. give me a call................
Yes, you can tell the type of cancer with a biopsy, my sister was diagnosed with an FNA biopsy, papillary cancer, like I have. Mine read "benign follicular clusters" which is inconclusive, they couldn't tell until the thyroid was taken out, but I did have cancer, and luckily it was papillary, very slow growing, very curable. Luckily, you have plenty of time, I know it is frustrating to have to wait...You may consider taking out the half of the thyroid with the nodule in it, then you would know for sure. That is how mine was found, then I had the total thyroidectomy later.
I don't know if even a biopsy could determine exactly what type of cancer is present.
You are doing reading on medullary cancer - which out of all the thyroid cancers that is the worst. There are 4 cancers.
I am sure you are stressed out on this - You also say there were no labs to determine the Hashi's? why not?
Thyroid cancer regardless of what kind - is very hard to actually prove - even with a biopsy. It is so tiny - ( Like a grain of rice) and if the biopsy needle misses it - ( lets say in cyctic fluid - then the biopsy can come out beign.
If I read right - 4cm - is fairly large - regardless and has growth present for sure. Who has suggested possibily taking it out.. anyone? That to me - would be best.
You are doing reading on medullary cancer - which out of all the thyroid cancers that is the worst. There are 4 cancers.
I am sure you are stressed out on this - You also say there were no labs to determine the Hashi's? why not?
Thyroid cancer regardless of what kind - is very hard to actually prove - even with a biopsy. It is so tiny - ( Like a grain of rice) and if the biopsy needle misses it - ( lets say in cyctic fluid - then the biopsy can come out beign.
If I read right - 4cm - is fairly large - regardless and has growth present for sure. Who has suggested possibily taking it out.. anyone? That to me - would be best.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
