possible reoccurance?

[bluebird777]

I was diagnosed with papillary carcinoma with a follicular variant in 2003. They removed my thyroid and isthmus and six weeks later...I was swallowing I131 pill and sitting in a lead room for about 4 days.

Six weeks after that...they said it was gone. The next year...had  a neck dissection and 16 lymph nodes removed and they found the cancer in 3 different places.

The doctors said that there was nothing they could do for me because the radiation didn't kill it. I ended up moving to the coast because frankly...i didn't know just how much time I had and want to live it where I wanted to live. About 6 months later...a surgeon did a total neck dissection and removed several lymph nodes and found no cancer. I was told that I no longer had cancer.

I did pretty good most of the time until about a year ago when a lot of my symptoms started coming back. Along with new lymph nodes in my neck and now swollen lymph nodes on my left side. I have a biopsy and a needle aspiration done about 9 months ago. They path reports are on my page. They basically say lymphoid dysplasia and lymphoid proliferation. I was told I have a virus.

Things have not gotten better. I now have more lymph nodes in my neck and swollen ones on my left hip down to the top of my left thigh. I also have a couple of small ones now on the left side.

I am being told that I don't have thyroid cancer anymore that it looks like a lymphoma. I have been asking a lot of questions and doing some research based on my symptoms...and it looks like it could be a virus or infection.

I'm giving you a little history to preface my question:

What is your take? Do you think thyroid reoccurance? lymphoma? viral? infection?

I am seeing a oncologist on the 19th...but something makes me wonder if this isn't thyroid because how slow it has been moving.

[Mark Lupo, M.D.]

Good question about thyroglobulin - a few points there:

1) Is the antibody titer (level) trending downward or upward -- that is used as a surrogate marker in patients with Tg-Ab's.
2) Did they do Tg-wash on the FNA of the current lymph nodes?  This is accurate even in patients with Tg-Ab's in the blood.

Otherwise,

You may need excisional biopsy (surgical removal) of one of the larger nodes to really determine if it is lymphoma or normal reactive node (ie to a virus).  The oncologist will help in making the diagnosis.

[bluebird777]

I meant to say flow cytommetry(SP).  lol

[bluebird777]

Thank you! I've been trying to figure out how to get around the antibody issue.

I want to say the antibody trend moves downward...but don't quote me on it.

No...they did not do a Tg-wash. I live in a small mountain community and the level/quality of care...even the level of testing...is not as good as from a larger city. Unfortunately...if you don't have insurance...as I don't...they run minimal testing. I can't even get them to fun flow cytology.

I'm starting to think that it's back to excisional biopsy again. Then we can determine virus/infection or cancer. At least now I know what questions to ask and what to look for.

What ever is going on has now spread to my right side.  Visit with the oncologist is next Wednesday...I guess I just have to be a little more patient. LOL no pun intended   :)

[bluebird777]

the thyroglobulin has not been a productive test for me because I have thyroglobulin antibodies.

Neither the thyroglobulin or thyroid uptake has been useful. Both of those tests came out negative...but the pathology report showed the cancer.

I realize now that their really isn't anything that can be done without another biopsy and I'm just not too excited about that.

Thank you for responding :)

[MANmom]

Sorry for your trouble, the only way I know to check for thyroid recurrance is to have a thyroglobulin test done, if your thyroglobulin is high after being given a thyrogen shot, you probably have recurrance.  You might ask your doctor about it.  Don't know if that is so in your case, but it is worth a shot.