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Follicullar Carcinoma *CBC with Diff*

I would just like my results explained. I had the blood work done because I am going in Friday for a partial thyroidectomy and Hemi thyroidectomy due to possible follicular carcinoms. FNA came back with follicular neoplasm cells and doppler showed intranodular flow. Biopsy samples were sent to Afirma (genomic testing) and it came back suspicious. My question is can blood work point toward or away from malignancy? Thanks in advance!

My Results

Hemoglobin- 15.7
Hematocrit - 46.1
MCV- 91.5
MCH- 31.2
MCHC-34.1
RDW -12.7
Platelet-353
MPV -10.4
ANC-5.2
Nucleated RBC 0
Neutrophils, Auto-64.2
Lymphs, Auto- 22
Monocytes, Auto-9.6
Eosinophils, Auto-2.6
Basophils, Auto-1.2
Immature Grans, Auto- 0.4
Neutrophils, Absolute - 5.18
Lymphocytes, Absolute- 1.77
Monocytes, Absolute- 0.77
Eosinophils, Absolute- 0.21
Basophils, Absolute- 0.1
Immature Grans, Absolute- 0.03
1 Responses
1530171 tn?1448133193
Most of your labs are within range with the exception of a few, which are either borderline high normal or slightly above normal range ( as you did not post your lab ranges, I used typical ranges).

The doppler sonogram test has a  65.2% sensitivity, 52.5% specificity, and 58.9% overall accuracy in  in differentiating malignant and benign  thyroid nodules.
The  follicular neoplasm cells without removing the lobe with
the nodule for further examination (the only way to get a fairly accurate diagnosis!), have only up to 25% possibility of being cancerous.
In cases where Afirma  classifies a nodule as suspicious for cancer, it is still not certain that the nodule is malignant.
Suspicious, in my opinion, means that further investigation is deemed necessary.
This test is only indicative and NOT diagnostic of the presence of cancer!
Afirma Malignancy Classifiers (BRAF+Rate) are accurate 19%-51% (that is a very wide range!) when they classify a nodule as suspicious for malignancy.
Source: Afirma website
Not a very strong indicator in my opinion for surgery recommendation
at this point.

You have made no mention of your prior medical history and symptoms, which plays a vital role in making certain important determinations.

Your scheduled thyroidectomy for tomorrow, unfortunately, puts you in a difficult position, as you have  no time to get a second opinion or further testing.

So, in conclusion, all this discussion might be pointless in the end.

Please note that my comments are not intended in any way, as a substitute for professional medical advice.

Best wishes,
Niko
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