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1563692 tn?1300340033

FNA Report

I just recieved the results from my FNA which i had this week.  I am yet to talk to the Endo, my GP gave me the results whilst i was there today.  They have come back inconclusive for malignancy.

The report reads:
Contents  of cystic haemorrhagic nodule, exact nature of which is undetermined from this examination.  Epithelial cell content is low.

The fluid consists mainly of foamy macrophages and other inflammatory cells in a granular protienaceous background.  Numerous crystal clefts and occassional bland epithelial cells, mostly dispersed singly, are present.  The appearences are in keeping with contents of a cyst, possibly in the setting of a multinodular goitere.

Can anyone out there shed some light on this mor me?  I understand that noone can diagnose me, but i have no idea what any of these words mean and what is normal and what is not.

Thanks
9 Responses
1425146 tn?1282765484
"Inconclusive" for malignancy in thyroid cases usually either means there is nothing at all, or you are at the "microscopic" stage of thyroid cancer. The report does not suggest the beginnings of carcinoma, but rather, a multi noduler goiter with a cyst, which is exactly what I have. I have had 3 biopsies in the last 11 months, as new tumors were found and others grew, and all have been "inconclusive."

You do have thyroid disease. An exact determination of which needs to be made. You have not listed any "symptoms" you feel, or "observations" mad by any of the physicians so there's little info to go on as to diagnosis. If you have that information, posting it on this Board will give many who have studied blood analysis of the thyroid gland to comment. However, the known cysts and multinodular goiter means you must "watch" this gland like a hawk (at least 4 times a year) with sonogram/ultrasound testing to "mark" the number, size, location, suspected composition (hard/soft, etc) as it's a medical fact that once cysts begiin to appear, cancer will occur more than 50% of the time, especially in women.

Australia and New Zealand have very aggressive study programs for thyroid disease and are studying the use of soy, in particular, soy milk, as a high probability cause of thyroid disease. Were you raised on soy? If not, do you have a diet high in soy or soybeans? You can find an article on this on my book website at whyamianxious.org.

Let us know your symptoms if any, test results if any (and if not, you need some) - And, Best in Health.
1563692 tn?1300340033
Thank you so much for you reply.

I am 27 yo and I have 3 kids.  My youngest is 6 months old.  I had pre eclampsia through my first and third pregnancies.

My dr checked my FTF and it has all come bak within normal ranges.

I don't eat or drink anything soy and never have.  

I am quite overweight but have lost 20kgs since having my last child without doing a thing except breastfeeding.

There is no known family history of any thyroid problems, though there have been a few family members who have had different types of cancer
1563692 tn?1300340033
The largest lesion was almost 5cm in size in my left lobe.  They aspirated 18mls of 'turbid brown fluid'
The endo said to me when he looked at my U/S that it was mainly cystic but around the edges there was some 'matter'
I also have a 3mm nodule in the right lobe and a 5mm nodule in the isthmus.  From what I can gather from the first report, these lesions are the largest in these places, suggesting there are more
1425146 tn?1282765484
You're most welcome for the comments if they helped any.

I've got to say, along with many on this Board, that having "blood tests come back normal" is not something to take confidence in, nor rule out sever thyroid disease (which is obvious from your u/s). A great quote from one of the member's doctors regarding another physicians ignoring a obvious goiter on her thyroid gland a few days ago said it all:

"I'm sure your patients will take great comfort that their labs are perfectly normal when they're dead."

Blood tests DO NOT rule out severe thyroid disease. It's that simple. They can rule it "in", but not out. The instruments are not accurate enough, and the suggested ranges are far too wide for a great many. Disregard the blood test argument if you get one, and seek another doctor who will begin treatment.

The cysts have to be calmed down from producing "dead" fluids like we've both had aspirated. These are the fluids that would help your metabolism digest and process your food and keep your weight off. The loss of weight you mention seems to be baby weight, I doubt your metabolic system is working properly, especially post partem. Almost 40% of women in America today experience temporary hypothyroidism after pregnancy, I doubt it's any different in Australia. But in any case, you had the weight gain BEFORE the last pregnancy so I doubt this is a "temporary" case, especially in light of the nodules.

Keep in mind, nodules are "tumors", just smaller in size and not exhibiting carcinoma characteristics. A fine needle biopsy should have been done during your aspiration? If not, you must have one ASAP.

Don't believe for a second that "no one can diagnose you", we just haven't found the right doc and tests yet.

Keep us informed as to your symptoms and continued testing. Best
1563692 tn?1300340033
I am now waiting on a call back from my Endo for my follow up appointment.

The whole thing is starting to really scare me!  Moreso that i know it can all be fixed, the waiting just seems to be taking forever and a day to get somewhere.

I do have a question though.  I have had my period now twice within 2 weeks, which is completely out of the ordinary for me.  I had Endometrisis after i had my last baby and this was fixed with a few courses of antibiotics.  I went on to have a regular cycle since my baby girl was 3 months old, she is now almost 7 months and this has happened?  I have looked on the net for some information regarding this and goiters but i am not finding much information.  Is this something i need to have looked at or something i can just put up with?  Sorry for the TMI!
1563692 tn?1300340033
I thought I might also add that after the birth oh of my second child (he is now 3.5 yrs) I suffered from Bell's Palsy, at 12 days post partum.  This lasted about 8 weeks.
1425146 tn?1282765484
This sounds like an OB/GYN issue that's probably not related (in my obviously limited opinion). But let's try a couple of simple, low cost, known healthy things.

1. Cut down or off caffeine. No soft drinks, coffee, chocolate, etc. Or, cut it back to 1 (that's ONE) serving per day. You will notice some headaches if you use a lot of caffeine, but they will stop in a couple of days and you'll be surprised at how you feel. If you are not taking ANY caffeine, this won't be an issue and can help your Doc rule out some possible diagnosis'.

2. A vitamin routine. Standard IU (international units), off the shelf, good quality vitamins:
pill form vitamin A, Mycelized vitamin A (liquid - taste's terrible, but WILL get your metabolism going), B-6, C, E, and Zinc. Regardless of what's going on with your thyroid and cycle issues, these vitamins WILL help you "regulate" a lot of functions.

Also, do not be scared or worry. Physicians are learning more every day, and you do not have a death sentence. We want to "watch" the gland to make sure the cysts and goiters do not "change character" or grow suddenly. That's when you need to get really pro-active.

Our foundation's site - nationalthyroidfoundation.org has a lot of articles that you might find interesting and educational. In addition, i would look at my books site - whyamianxious.org for a symptoms list to fill out when you visit the Endo. Be as prepared for the doc appointment as a job interview. Have your own list of questions you want answered - and don't leave until you get it!

Relax, and keep us posted.
1563692 tn?1300340033
Thank you!!!
1563692 tn?1300340033
Hi, thought I would quickly update since I met with the endo again.

The goiter is now 2cm instead of 5 and is basically solid.  I have been given the option of sitting on it for 6 months and having another ultrasound then, or be put on the list to meet with the surgeon to look at a total thyroidectomy.

I have asked to see the surgeon, but am unsure of what to do just yet.  I dont want to prematurely have the entire gland removed, but I also would like some answers!
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