FNA Impression

[sabato]

Had a FNA on nodule on my right thyroid . Having a difficult time understanding the comments on the pathologic
impression . Surgery recomended by the surgeon that did the FNA to biopsy thyriod for cancer . Not sure if need
to have surgery. ???
FNA biopsy pathologic impression . Follicular lesion...
Comments;
Smears reveal numerous two dimesnsional cellular groups of follocular epithelium showing repetitive microfollicular
architecture. Some smears conatian amounts of colloid, while others have more abundant thin watery collid. Rare
macrophages are also identified. Classic cytologic features of papillary thyroid carcinoma are not present . The
differential diagnosis includes follicular adenoma, ademomatous cellular nodule,nodular goiter, follicular carcinoma and less likely follicular variant of papillary thyroid carcinoma. Clinical correlation and follow up recommended.

I

[sabato]

Thank you for the excellent info . It is much appreciated . Have plenty to research ....

[ChitChatNine]

WOW you got some great info here!  Thanks everybody!

You can go to Dr. Lupo's community and put in a community search to find the institutions that he suggests for 2nd opinions.  That may help before you are able to get your ? in.

C~

[898]

The mass which has cystic component is undergoing cystic degeneration so it may eventually become a complex cyst.
The large nodule can grow due to inflammatory and degenerative process in it ( can be degenerating follicular adenoma; macrophages can support this version).Presence of abundant watery colloid and Foamy macrophages favors benign lesion [Nature Clinical Practice Endocrinology & Metabolism (2006) 2, 384-394], while Microfollicles suggesting neoplasm [can be benign or malignant].http://www.nature.com/nrendo/journal/v2/n7/full/ncpendmet0215.html.
the amount of watery colloid in the sample is critical to provide good info for accurate diagnosis.

[sabato]

Thank you for the comment . I am having  a different cytologist assosiated with a different
medical center look at my samples. Should hear from them this week. My nodule started out small ( found in 07, 2 cm x 1.5 cm) but has grown in the last year  2.4 x 2.2 . I have two masses in the right lobe which when biopsed in 08  found benign. One of these masses unchanged the other which was solid now has a cystic component . I have put
surgery off till the end of the month so as to make sure I have all info and understand
the impressions. Not 100% sure surfery is needed ....

[sabato]

Thanks for the welcome  I have been trying to get the ? to Dr. Lupo but the forum
is full will try again later ......

[898]

The possibility of follcular neoplasm was made based on the "repetitive microfollicular
architecture" finding, however the malignat lesions containg very little colloid [opposite to yours];also presence of macrophages points to inflammatory process within the nodule, which is not common in the malignat lesions. you may have get another cytologist to look on your sample before proceeding, especially if nodule is small.

[ChitChatNine]

You may want to try to get on to our experts community. Dr. Lupo is really good at helping as well as a few members here who may be able to better answer your ?.  I'm not really too familiar but wanted to stop by and say welcome to the community and hello.

C~
parital TT 1/07