Thyroid Disorders

[Scogirl]

Dr. Lupo,
     I recently had a thyroid ultrasound which revealed a complex, mostly solid thyroid nodule on the left side.  I then had an ultrasound guided Thyroid FNA.  The pathology report is as follows:  A.  Left Thyroid Lobe, FNA:   Suspicious for a Follicular Neoplasm (see comment).  Comment:  The fine needle aspirate shows tightly clustered small thyroid follicles with the follicular cells showing no significant atypia.  The FNA material also contains scant colloid and
macrophages.  The differential includes a predominantly microglandular adenamatous nodule versus a follicular neoplasm.  B.  Tissue labelled "Left Thyroid Lobe, Needle Biopsy":  Benign appearing Thyroid tisssue composed of varying sized Thyroid follicles with a predominance of small follicles.  No malignancy identified.  Diagnosis Comment:  Based upon the combined specimens (A and B), a lesion of a benign adenomatoid nodule is favored but a follicular neoplasm cannot be entirely excluded.  In your opinion, should I have surgery to remove the nodule?  Thank you.

[blsdnsvd]

I was in a similiar situation as yourself, having the same diagnosis on one side and hurthle cell neoplasm on the other...I also had a benign result from the fna, but follicular neoplasm could not be ruled out. I had a TT on 12-17 due to the abnormal cells on both sides. My pathology report was benign for cancer..Thank God, however, i am relieved that i had the TT. I am assuming that you would b recommended to have at least a parital Thyroidectomy due to the cells that are there. You should have more than one opinion in order to determine what should be done.  

[MANmom]

I am no doctor, but you sound like what I have experienced.  It is frustrating to get that diagnosis!  I had four nodules, three on the right, one on the left.  Largest 2.1 cm, three solid, one complex.  Biopsy revealed "benign follicular clusters", but I still had cancer.  The fact that the cells are clustered is a concern--seems they are more likely cancerous than if you had cells that were random. I only had one nodule tested, the biggest one, that one did not have cancer in it, but they found the cancer in the thyroid tissue itself.  I removed the right side initially to hopefully cure my hoarseness and to test for cancer.  They found three microscopic tumors in the right side.  Then we had the other side removed, the one with the complex nodule, that was where the big tumor was, 1.5 cm. Are you having any symptoms?  If they are bugging you, take them out.  If not, have them re-tested in 6 months.  Luckily, thyroid cancer is almost 100% curable in most cases, and it grows slowly except in the case of certain more rare forms, so you have time to think about it.  Do you have siblings with thyroid disease?  My thyroid issues are familial, dad, two brothers have Hashimotos, as did I, and after I was diagnosed, my sister went in and was tested, she had the same cancer.  My other siblings are also being tested, out of the nine of us, so far five have thyroid issues.  Keep searching for the answer, remember, you still only have about 20% chance of having cancer, but it is important to get the answer.  Good luck.