help with pathology report

[Dannie17]

Hi, I have had a thyroid ultrasound, thyroid uptake (123), and a recent thyroid biopsy but my results came back indeterminate and my PCP has now referred me to an Endocrinologist whom will be performing another biopsy in June. Problem is no one has gone over my pathology report with me, and I do not understand all of the wording. Please help me understand what my pathology report means. From my own research it sounds like possible papillary carcinoma, but their are no psammoma bodies seen which could possibly mean that it isn't papillary and maybe follicular. Its al so confusing. Thanks for any help.
The ultrasound indicated a complex right lower lobe nodule measuring 1.7 by 0.9, based on that I had the uptake which indicated that the nodule was cold, based on that I had the biopsy.
Diagnosis: "1 cytospin and cell block/FNA right thyroid"
specimin adequacy: adequate but somewhat low follicular cellularity. Diagnosis category: Indeterminate. Diagnosis: atypia of undertermined significance. See comment.
Comment: The main cellularity within this specimen is in the cell block. If a nodule exists, core biopsy or removal is suggested for further elucidation of the process.
Microscopic description: Cytospin: the cytospin consists of a single group of follicular cells with minimal atypia in a background of blood. No histiocytes, colloid material, or psammoma bodies seen.
Cell Block: The cell block consists of a group of atypical cells with mildly enlarged nuclei, nuclear clearing, nuclear grooving, irregular nuclear borders and focal small nucleoli arranged in small groups, linear arrangements and focal microfollicles. Some focal fibrotic tissue and fat cells are seen. Focal heterogenous colloid material present. No histiocytes or psammoma bodies seen. Background blood and focal blood elements are seen.
Thanks again for your help.

[Mark Lupo, M.D.]

The number of cells is low.  The classification of Atypical is probably appropriate -- meaning repeat FNA will be necessary.  Also it may be useful to send the slides to an expert thyroid pathologist (such as Dr Massoll at U Arkansas or Dr Baloch at U Penn).  The cell block did show potentially suspicious features but apparently not enough to call cancer or "suspicious for cancer"

[gunmetal83]

this means that the news is not very bad, they have found some sort of follicular elements but the cells are very similar to normal and not wildly malignant. you should see an endocrinologist stat, who can refer you to a surgeon for possible partial throidectomy and further evaluation of the removed thyroid tissue....