I've had two FNABs within the last six months, and now my endocrinologist is proposing another.
First FNAB sent for cytopathology to our local WV hospital came back indeterminate with atypical cells suggesting a possible follicular neoplasm. Then a second FNAB sample was sent for Veractye gene expression classifier testing. Result: not definitely benign, but 40% suspicious for malignancy. I want to avoid unnecessary surgery, so a sample was sent to John Hopkins university for another cytopathology. Result was one word: benign.
However, my endocrinologist now says she is not comfortable with benign as the final word, although she has been supportive of my desire to avoid unnecessary surgery, a thyroidectomy primarily for diagnostic purposes. She does say my ultrasounds have shown a single nodule only one centimeter in size that does not have suspicious characteristics. Now she is proposing another FNAB with results sent to miRinform for molecular testing. She says because I have been very compliant over the last several years with tx for Grave's disease, she is willing to continue with testing instead of referring me to a surgeon. I would appreciate another opinion on why John Hopkins' very definitive one word dx of benign can't be the final word.
After a year of methimazole tx for Graves' disease which ended in Oct. 2013, my TSH and free T4 were normal until 2014, when TSH weirdly was high. Even on 12.5 mg of synthroid, last months labs showed TSH at 9.5. She did not have time to explain why, but I am very curious. Previously my radioactive thyroid scan (diffuse markedly increased uptake), antibody labs, TSH, and free T4, eye symptoms and others symptoms, unequivocally pointed to Graves. I've been off methimazole for months now, so why the labs showing hypothyroidism? A two-part question. Thank you for any response.