understanding pathology report

[Dannie17]

Hi, I have had a thyroid ultrasound, thyroid uptake (123), and a recent thyroid biopsy but my results came back indeterminate and my PCP has now referred me to an Endocrinologist whom will be performing another biopsy in June. Problem is no one has gone over my pathology report with me, and I do not understand all of the wording. Please help me understand what my pathology report means. From my own research it sounds like possible papillary carcinoma, but their are no psammoma bodies seen which could possibly mean that it isn't papillary and maybe follicular. Its al so confusing. Thanks for any help.
The ultrasound indicated a complex right lower lobe nodule measuring 1.7 by 0.9, based on that I had the uptake which indicated that the nodule was cold, based on that I had the biopsy.
Diagnosis: "1 cytospin and cell block/FNA right thyroid"
specimin adequacy: adequate but somewhat low follicular cellularity. Diagnosis category: Indeterminate. Diagnosis: atypia of undertermined significance. See comment.
Comment: The main cellularity within this specimen is in the cell block. If a nodule exists, core biopsy or removal is suggested for further elucidation of the process.
Microscopic description: Cytospin: the cytospin consists of a single group of follicular cells with minimal atypia in a background of blood. No histiocytes, colloid material, or psammoma bodies seen.
Cell Block: The cell block consists of a group of atypical cells with mildly enlarged nuclei, nuclear clearing, nuclear grooving, irregular nuclear borders and focal small nucleoli arranged in small groups, linear arrangements and focal microfollicles. Some focal fibrotic tissue and fat cells are seen. Focal heterogenous colloid material present. No histiocytes or psammoma bodies seen. Background blood and focal blood elements are seen.
Thanks again for your help.

[898_1]

It seems like bigger part of the specimen contained blood.
fibrotic tissue mean the presenceof  some sort of scarring process
Nuclear grooving of the cells is what probably brought suspison about malignancy therefore it will be very good idea to have some experienced pathologist to look on them.
"The presence of nuclear grooves is NOT specific for papillary thyroid carcinoma because it has been documented in other types of thyroid neoplasms"(Pathogenesis and Diagnostic Significance of Nuclear Grooves in Thyroid and Other Sites by
Anna Batistatou and Chrisoula Scopa)
"Eighty-eight percent of papillary carcinoma had nuclear grooves in > or = 20% tumor cells, whereas none of the other thyroid diseases exceeded this level." Your report should specify what %% of the specimen cells has nuclear grooves.

[blsdnsvd]

You are heading in the right direction as far as seeing an endo for followup and 2nd biopsy. After this, you shall seek at least one more opinion and take it from there.

I also had a cold/nodule that was 3.7cm.. and others that were benign on the fna but suggested surgery due to the cells (follicular and hurthle) that were present. After surgery, the pathology report was also benign however it was a better safe than sorry decision.

There is an very experience person on this site that can explain in detail what your results mean.