Suspicious ultrasound and benign FNA

[ultramichelle]

I am now uncomfortable pressing for a second oppinion reguarding the new 1 cm lesion inthe right gland.( image next to my name) I was told it was probably papillary carcinoma and it had several characteristics of it like the punctate calcifications, hypoechoic and flow within on teh ultrasound. FNA results said follicular cells with focal metaplastic changes andscattered  lymphocytes and colloid present. How can the results be so differant? The endo doesn't want to see me for 12-18 months. In this time period if it is a cancer the likelihood of lymph node spread is a big deal or no big deal? If it is some sort of infection why wasn't I given anything to clear it up? Would a lab test show that? How long for that to clear up. should I ask for another biopsy? If so when is resonable?
My labs were normal. I hate waiting and feel like its all out of my hands and unsure what to sit back and wait for.

[ultramichelle]

Now I just need to plan for the RAI I have a 1 yr old and a 4 yr old. I hope I can weather the distance from my family, did anyone move out of their home? I feel a hotel woudl not work since the future guest of the room may get contaminated. NO close family to keep me, any good suggestions??

[ultramichelle]

Good luck, a few weeks will be here in no time.

[Linda355]

Good luck to you and so glad you found the answer :)  Mine is still a mystery and hoping I can get some firm answers when I finally get to see an Endo in a few weeks.

[redheadaussie]

Glad you got the 2nd opinion! Was unaware your profession was an ultrasonographer, which is obviously why the rad told you what they did.
Now you know what you are dealing with you can make that journey to wellness!
Cheers and good luck!

[ultramichelle]

I am glad I did too, I also am in San Diego and went to Santa Monica for the 2nd opinion and glad I did, but I really knew it could not have been right that first time and I am bummed the 1st endo did not  do me a good service and I knew enough to look elsewhere...with all  your encouragement.

[MANmom]

WOW!  At least now you know!  Looks like you will be having surgery soon, I am glad you persued it and asked for that second opinion...good luck with the surgery.

[ultramichelle]

Well I think the Rad was so forthcoming since I am an ultrasonographer. I had my second bx yesterday and it came back Papillary cancer, so I thank everyone for helping me get to a secong opinion out of my HMO.

[ultramichelle]

I had the biopsy done again today by another endocrinologist and he also did a lymph node that looked abnormal. I should have results by Monday. Thank you all for the input I am relieved to get a second opinion. He did talk about Hasimoto's  and also cancer, so we will see.

[redheadaussie]

Your results are not different, it was a radiologist stating one thing and your FNA another! The radiologist is basing their opinion on previous experience of visual information. The FNA will show what is going on in the nodule.
  Follicular cells with metaplastic changes means it is changing into something else. What into is in the lap of the Gods. It may not change for a very very long time or it may change in months. The fact you have scattered lymphocytes can mean you are developing an auto-immune thyroid disorder. Hashimoto's being the prominent one with lymphocytes.

  I would be asking a 2nd opinion. Many doctors will do a watchful wait to see what happens but some will be more aggresive in their treatment.
The radiologist technically should not have said anything to you. They should have made the report and sent it to your doctor for discussion. You have probably been worrying needlessly.

[blsdnsvd]

1 to 1 1/2 yrs with abnormal cells (follicular cells) not a good idea. I would search my insurance provider book and find another endo....i had too and i did. Most endo's would want to see their patient with a thyroid issue at least in 3mos...not that long.

Best Wishes and always stay on top.

[ultramichelle]

thankt0 you all, I am seeing an endocrinologist and I felt like I was putting her out and she doesn't want  to see me for another 1 to 1 1/2 yrs now. UGHH. That just sounds wrong. I will press for the 2nd oppion of another endocrinologist. I appreciate the time you all have putting into helping me get my mind at ease and in the right direction.

[MANmom]

I am with blsdnsvd, FNA's are often wrong.  Think of it this way, some of my tumors were only 1 mm to 2 mm, about the size of a pin head.  Now try to hit that area inside someone's neck with a needle...it is VERY hard to hit a cancer tumor that size, and if they do it is sometimes hard to extract cells.  My biopsy came back "benign follicular clusters", I still had cancer. If they had biopsied the noduled that was the second-biggest, that one was all cancer (1.5 cm) and they would have had a different result.  I am NOT saying you have cancer, but the nodules should be watched, and if you are having symptoms, i.e., hoarseness, swallowing difficulties, etc., you should take out the part of the thyroid with the nodule and have it checked by a pathologist.  Sometimes they just can't tell unless you get it taken out.

[boots460]

Don't be concerned about asking for a second opinion.  Doctors are professionals and are used to this.  I recently went to a second endocronoligist for a second opinion and it certainly was worth it.  If nothing else you will feel much more knowledgable about what is going on and what treatment options are available.  Go in with a list of questions and concerns.... i have also learned to ask for a copy of all my test results for a file.  That way if you end up with a new doctor you have all the previous info available.
Best of luck!

[blsdnsvd]

Are you under the care of a Endocrinologist??? If not, please find one asap and get a second opinion...FNA's are not 100% and at times cannot tell the difference between malignant and benign when it comes to certain cells such as: "follicular" and "hurthle"...
Waiting that long should not be recommended.

[ultramichelle]

the radiologist said he thought it  was classic for papillary carcinoma and wehn the results fromthe FNA came back he said they were wrong, but to watch it.

[armywife92]

I may be mistaken but if one has hashimotos, lymphocytes and follicular cells can be present. If the cells come back benign that is usually the recommended time to repeat tests. When one doesn't get a FNA and the nodule is present and doesn't look suspicious, most times they will repeat another u/s in 6 months. I would get a second opion just to be on the safe side.

[blsdnsvd]

Who told you that it was probably papillary carcinoma???
If your results came back with having "follicular cells"...this is a cause for concern because it's hard to diffrentiate between normal and abnormal cells on the fna and waiting 12-18months is too long!

My results were benign with follicular cells present as well as hurthle cells on the other cell and my recommendation was to: REMOVE the entire thyroid, which i did months later. These findings do not clear up so if I were you, i'd get a second and possibly third opinion, as I did and take it from there.