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Anyone Know What Atypical Cells Mean?

Does anyone know what Atypical cells on a thyroid biopsy mean?  

I have a multinodular goiter with only one nodule showing as cold on a scan (approx. 2.2 cm's).  I had a biopsy done in November of 2006 on that one nodule (rest of nodules were hot on scan) which came back as "normal thyroid cells" on pathology.  May of 2007, no further growth on an ultrasound.  Rechecked with ultrasound May 2008 and showed "slight growth".  I was sent for another biopsy at which time, the doc performing the biopsy said that my nodule was "partially cystic" (no one had said that before, including my endo).  The cells on this biopsy came back as "atypical" and I'm being scheduled for surgery now.  My endo would not explain or elaborate (very clinical and evasive in answering anything normally so, hard to judge).  

Anyone know what this means or, had similar findings?  

I'm scheduled to see the surgeon on the 30th of September at which time, I guess they will set my date for surgery.  Needless to say, I'm quite the nervous wreck already!  

Anything anyone can share with me would be so much appreciated, including how long a hospital stay it generally is for thyroid surgeries....anything that might help me both understand and feel a little calmer would be so welcomed!

Thank you all in advance!
24 Responses
213044 tn?1236527460
Atypical means not normal.

It sounds like they think it is suspicious, but they did not specifically use the word cancer or any of the terminology used to describe different types of thyroid cancer.

FNA results are often inconclusive. Suspicious is enough to schedule surgery. The surgeon will often biopsy the removed nodule and then decide how much of the gland to remove, all while you are in the midst of surgery.

I didn't have surgery, but I believe the hospital stay is only a day or two unless you start having trouble with your parathyroids.

Best of luck with your surgeon appointment.
Avatar universal
Thank you for taking the time to respond!  That was so nice of you!  

I knew atypical meant that the cells weren't normal but, unfortunately, my endo would not give me any idea what "not normal" meant or what other possibilities there were (besides the possibility of cancer that is).  All that he would say is, "it means that we do surgery" and ended the conversation there.  *SIGH*  I'm sure that besides cancer, there must be some other possible explanations as to what the cells could be but, of course, specialists seem to answer as few questions as possible with as evasive/open ended an answer as they can come up with.  *smile*  They're pretty good at it too! *wink*

Thank you so much for your best wishes as well!  I hope that perhaps, the surgeon will be a little more informative at the least.  

With my best wishes to you in return.  
393685 tn?1425812522
Good Luck on the road to figuring it all out.

I think some doctors don't want the "C" word thrown out of their mouths either.
That's maybe why they let the surgeon's deal with that conversation end.

Avatar universal
Thank you Stella.  

Yeah, so true.  It seems that when they do utter the "C" word though, they seem to treat it with a rather "flippant" attitude when it comes to thyroid.  I asked about the possibilities and the answer was (both from my endo and then, my family doc)  "It's not like any other type of cancer in the body.  It's slow growing, we simply take it out and it's done."  Yet, reading ANYTHING about thyroid cancer on the net certainly doesn't leave one with that "calm" an attitude about it, does it?  

393685 tn?1425812522
no it doesn't

but it is very curable and you will be fine -
158939 tn?1274915197
My family has a bit of history with all of this.  Four of us have full-blown thyroid cancer and another two have "atypical" thyroids - meaning "precancerous".  The way it was explained to me by multiple doctors is "atypical" means "not normal" or "abnormal" cells which are either on their way to turning cancerous or have already started turning to cancer.  It is possible to have both cancerous and atypical cells in the same thyroid.

Best way to know for sure is to get it out and sent to pathology.

The surgery is typically just an overnight stay (at least was for the 7 surgeries in my family . . . I had it twice) and, of all the surgeries we've experienced, is a pretty easy one to recover from.

Ask your surgeon how many of these surgeries he/she does in a month.  You want someone experienced in thyroid surgeries.  If this isn't a surgery the surgeon does a lot, find another surgeon.  Also talk about the parathyroid glands - they are small glands near (or sometimes in) they thyroid that need to be saved if possible.  There is *often* calcium problems associated after thyroid surgeries because the parathyroid glands have either been disturbed, damaged, or removed.

Ask away, that's what we are all here for.

Best to you

papillary carcinoma '03
recurrence and RAI '06 and probably '08
three sisters with papillary carcinoma (one with three recurrences)
sister and daughter with atypical thyroid cells
168348 tn?1379357075
I had two atypical nodules that turned out to be 100% totally benign upon final biopsy but the pathologist who did the FNA came out to talk to me himself and examine my thyroid and told me in my case that 25% of any atypical nodules will turn into cancer if not cancer today.  THAT alone was made my decision.

Mine were overgrowth of thyroid tissue which I guess is atypical but not cancer atypical .. so when atypical comes up not worth taking any chances .. when you get atypical moles taken off they go back in and rexcise them clean to the margin so the same with your thyroid.

They found two tiny cancerous tumors in there upon final biopsy which we never knew I had .. so I am very happy I had it out .. they are GONE!

1/07 partial
TSH 1.8
Synthroid 75mcgs
papillary microcarcinomas (2 small ones)
Avatar universal
Thank you Utahmomma!  Wow, what a history you have of it in your family!  I have no one in my family thus far who has been diagnosed with anything wrong with their thyroid, although, one never really knows as more often than not, an annual physical simply means a TSH level done and no palpation of the thyroid.  So, there may have been and we simply didn't know....they passed away from other causes.  

Your situation has put the "facts" to rest from what I've read on different sites on the net.  I kept reading that a thyroid nodule (not the same with other parts of the body apparently) do not "turn cancerous"....they either are or they aren't right from the start???  But, it seems that your situation may be one that certainly shows this info to be not so true!  

I'm so sorry that you've had so much to go through!  You and your entire family!   You all must be "pros" at it by now and I thank you ever so much for being here for me to answer my questions!  It's so reassuring to hear of others who have gone through this and know what I am feeling.  

May I ask where yours is reoccuring?  Is it the lymph nodes?  I'm sorry to ask so many questions, it's just that I'm not understanding why or where it reoccurs if they remove the entire thyroid?  Sorry, I'm just confused and trying to understand and figure this all out as I go along.  And, once they removed the thyroid and did RAI, that still allowed it to regrow?  

Thank you for the reassurance with the recuperation from this surgery and hospital stay!  One day is certainly manageable and it's good to know that it's not a painful or long recovery!  *smile*  

The surgeon that I've been set up with apparently, does 10 to 12 thyroid surgeries per week/30 to 36/month my endo told me (I asked that question *smile*)  He says that she's an expert at what she does.  She also specializes in voice recovery surgeries (which I hear is one of the possible complications in thyroidectomies) so, if she screws up my voice, I guess she can also fix it too! *grin*  Is that considered enough surgeries in your experiences with your family and history?  Or, should I be looking for someone else?  

By the way, I see that your daughter and sister also have atypical thyroid cells.  Are they or have they also gone through surgery for this?  

And, this may seem like a silly question but, are you all living in the same region/area that may be causing this much within the family or is it all hereditary?  

Thank you so very much for taking the time to answer these questions for me!  I really very much appreciate this!!!  

Avatar universal
Hi ChitChat:

Thank you also very much for sharing your story with me!  It makes me feel more at ease to know that there is a possibility that this nodule can be benign even with atypical pathology!  

If I might ask one more question here.....when they did your surgery and found out that it was benign, did the surgeon remove the entire thyroid anyways or was it only in one half of it?  I was told that if it was benign, they may not remove my entire thyroid.  But, in your case, it turned out that you had these tiny malignancies anyways which has me worried that I may end up in a case like yours was and more surgery down the road that got missed???  

Avatar universal
Thank you Stella!  It's always very reassuring to hear those words of encouragement!  
158939 tn?1274915197
All of us in the family had thyroid surgeries.  I was the first.  They found a *small* (5mm) suspicious nodule which was partially solid, partially cystic and had irregular borders.  Being aggressive (and against many doctors advice), I opted for surgery and they took the right lobe.  The nodule was cancerous - which they didn't discover until I was in recovery or they would have taken the entire thing out.

A few months later my youngest sister was in a minor car accident.  They found a nodule on a chest x-ray.  She had an FNA which was benign but decided to have it out anyway.  Her cancer had spread to the lymph nodes.

Over the next few months the other three sisters had ultrasounds - all had nodules.  One opted for a FNA which was negative.  All had their thyroids out anyway.  Two were cancerous (including the one with the negative FNA) and the other was atypical.

I promptly went out and had my kids thyroids scanned.  My daughter had multiple nodules (including one compressing her jugular) and my son's was perfectly clean.  We had my daughter's out and it was full of atypical cells.

A few months later I had the left lobe out which was completely benign.   I'm glad I did though because two years later I had a recurrence (in my thyroid bed and some in my liver).  Last year my followup scan showed some uptake in my sinuses and liver again.  Don't know where we will find this one but my thyroglobulin and TSH are climbing again.

Oh, the youngest sister - the one with it in her lymph nodes - had three recurrences with RAI - the last one recurred in her breasts and salivary glands.

My sister and daughter with the atypical cells get their TSH and thyroglobulin levels checked every 2 years to see if the remaining thyroid tissue (surgery can't get it all) turns cancerous.   My sister missed her appointment a few years ago and now has a hard lump in her thyroid bed.  I'm begging and pleading with her to get in to see the endo!

My family has been in a genetic study and so far they can't find a link.  All of my sisters and I grew up in a suburban area of Utah but drank well water (remember the nuclear testing in Nevada).  They say we are too young to have been affected by that but it makes me wonder.  My daughter didn't grow up there and wasn't exposed to that water.

Your doctor doing 12 surgeries a week is great.  Sounds like you found a great one.   My sisters, daughter, and I all had the same surgeon and we just love her (she also did my son's gallbladder).  When you find a good one, hang on to them!

Hope I didn't miss any questions.  If I did, let me know here or just PM me.

Best of everything!!!

301640 tn?1302652334
i think atypical cells means precancerous i know im the only one in my family with thyroid probs but the family does have weight gain probs my tumors as u know was right and left lobe both were cancer
Avatar universal
Wow, Utahmom, you have really all been through the proverbial ringer with this!  You must be very anxious each time you have to go for testings for this.  You have to be a very strong woman and have a very strong family too!  How do you deal with it? HUGS!
I'm sure that you've adapted some sort of coping strategy in some way or another???  

I was reading how "rare" thyroid cancer is supposed to be, but alas, here are many people on these boards who have had to deal with it.  How is it that they say that only 10 to 15% of nodules are cancerous when so many seem to have it?  I know that I walked away from my initial consult with the endo thinking..."Ok, so that leaves 85-90% in my favor!"  Now, I'm beginning to wonder if the odds are much lower for a lot of us!

I have none of the "risk factors" that they cite.  I have no radiation exposure (other than normal dental xrays etc. that everyone else has), no history of it in my family, ate and drank all of the same foods and water that everyone else around me has had....am 52 years old, normal TSH and other blood thyroid factors tested.  I have had a goiter for nearly 20 years now though and have had it scanned about 18 years ago but, everything was deemed "fine" back then and my thyroid function were all and have all been "normal" all the way along.  

It's a head scratcher, isn't it?  

By the way, how old were you all when you were diagnosed or, these nodules were found?  

158939 tn?1274915197
I had none of the "risk factors" either.  :-)   There was NO thyroid cancer history . . . until me.    My sisters have told me to quit finding new things to come down with 'cause they are getting tired of sharing in my "fun"

We claim we are the 1% of the 1% - now if we could just make those odds work *for* us in Las Vegas!  LOL

You're going to find a very high percentage of people on this forum with thyroid cancer 'cause we tend to hang around for support and to give support/advice to others.  We see hundreds come and go every year and when they find out they are fine they move on to other things.

How do we deal with it all?  Sarcasm (then we cry when no one is around).

HUGS to you!!!


158939 tn?1274915197
Oh, oops, you asked how old Ii was when I was diagnosed:  37.  

Youngest sister (one with three recurrences and initial spread to lymph nodes) was 24.

My daughter was 16.

This November will be my 5 year anniversary of the diagnosis so we'll see if I get to celebrate with another full dose of RAI for another full-blown recurrence or if it is still in "watch and see" mode like it was last year.  :-/
Avatar universal
I'm smiling here because sarcasm works, doesn't it?  I, too could be entered into 100 contests with 9 out of 10 odds of winning and win nothing!  Put me in the 10% category of having something that is considered "rare" where there are 85-90% odds on the good side and I'll be in that 10% for THAT!  *grin*

Thank you for explaining that those of you who have or are dealing with thyroid cancer have been hanging around to help others and that hundreds do pass through here who are fine and do move on.  That makes it feel a little more in perspective!  But, most of all, THANK YOU for being HERE to help those of us who are going through the stages.  Your wisdom, understanding and experiences ARE helping those of us who are scared beyond belief.  So, just THANK YOU for being here!  HUGS!!!!!!

I'm so keeping my fingers crossed for you that you don't have to deal with anything further and no more RAI treatments!  I so hope that you end up getting a clean bill and get to go out for a lovely dinner to celebrate!  

Wow, 37, 24 and 16!  That is YOUNG to have found this but, glad that it was found and treated.  

How was the RAI treatment?  Were you isolated in a hospital?  What was that like?  (I'm TERRIFIED of being isolated and unable to leave!)  Were you sick or anything?  How did you cope with it?  

HUGS Utahmom!   HUGS!!!
158939 tn?1274915197
As my statistics professor used to joke:  "97.3% of statistics are just made up."

RAI treatment wasn't bad at all.  It was having to go hypo (we lovingly refer to it as "hypohell") that was a giant pain!  Thyrogen shots are much, much better.  Isolation was actually nice - everyone just left me alone.  I did it at home and watched TV, read books, cleaned house, and took naps.

HUGS to you my new friend, HUGS!!
Avatar universal
I'm chuckling here because it seems that you're so right in saying that statistics seem to be made up! *grin*  Statistics tend to change like the wind, it seems.  

As for RAI, most people that I know of have had to stay in hospital for a few days in isolation.  That really *****!  No visitors and they've said that they had to even stand back from the door as their food was shoved in on trays.  I'd go NUTS if I had to do that!  I don't mind being on my own at home and away from others but, doing it in a strange place.....well, let's just say that I'd feel like I was in prison.  

You have my hugs and my prayers that you get to CELEBRATE this year!!!!  *SMILE*  
Avatar universal
I am in a small New Mexico town. FNA suspicious with atypical cells.  Is it best to go to general surgeon or ent in a larger town.  Surgeion here has done approx 70 thyroid surgeries.  How painful is the surgery?  I am so freaked by all of this.  Surgery scheduled for 1-2 weeks.
Avatar universal
What symptoms did your daughter have at her age? My Grandmother had throat cancer, my mother thyroid cancer, and now me at age 37 I have atypical findings.  My daughter has not the best blood test for thyroid levels but not enough to worry yet they say...but that was before yesterday when I was told I needed to have surgery to remove all of my thyroid....So lost and confused...we probably should be a study also because some of my cousins are also having some of the same symptoms and are going to have test run.
Avatar universal
Just diagnosed with abnormal thyroid cells. Seeing an ear, nose, throat dr. tomorrow.Of course I'm scared. The C word is NOT one I want to hear.I take low thyroid meds now. After reading this stuff, it kinda makes you wonder, huh?What adverse affects from removing the thyroid? Also sounds like there is a high recurrence rate in the individual and with family members. I am concerned.Anything else to add to reassure me??? Thank you,
649848 tn?1534633700
Don't let this thread scare you.  The above posters are no longer active on the forum, but just so you know, utahmomma was not a typical thyroid cancer patient.  There really is not that high a rate of recurrence of thyroid cancer or with family members.

While there's always cause for concern, it's best to be optimistic.  Less than 5% of all thyroid nodules turn out to be cancer and as was noted above, it's very curable.
Avatar universal
Thanks for your reassurance.  I just found out I have atypical cells.  Praying that all is well and just would need watched.  Do not want cancer or even to get thyroid out.  Just Believing.  This forum was very scary.  Will also take natural remedies.
649848 tn?1534633700
I'm sorry to hear that you have atypical cells...  Just be aware that cells can be atypical, without being cancer.

Is it the whole forum that scares you or just this thread?  Don't let this get you down - it sounds a lot worse than it really is.  

Whether you'll be able to use natural remedies or not, depends on the actual outcome of all your tests.  Typical treatment for thyroid cancer is removal of the thyroid - there's not much else they can do, as they have to get rid of the cancer.  But of course, you don't know yet, if you have cancer, so we'll pray that you don't.

Will pray for the best for you.   Please be sure to let me know what you find out.

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