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FNA pathology report advice

TX Diva
Posts: 4
Joined: Jul 2011

Here are my Fine Needle biopsy results:

Follicular Epithelial Cells and Rare Hurthle Cells

Comments:
No definitive colloid is identified in this specimen. The cytologic differential diagnosis includes nodular goiter and follicular neoplasm. Nodular goiter is favored somewhat, but clinical correlation is also needed.

Nurse Assistant at Endo discussed results at follow-up visit following biopsy. She said no cancer so nothing to worry about...re-check via ultrasound in one year. I left glad no malignancy was found but troubled that I didn't get to consult with Endo himself. After researching results on internet, discovered that possibly the only way to get definitive "begin vs. malignant" diagnosis is surgical removed of nodule. Why didn't Endo suggest that? Should I take results to another Endo for second opinion?

Nodule is 2.3 cm, also have second nodule on other lobe .08 cm.
2.3 nodule is vascular.
I was exposed to xray radiation weekly for a period of one year, 40 years ago as an infant because of TB.
Thyroid levels have always been normal. Numerous symptoms is what caused discovery of nodules to begin with.

I just want to make sure observation is the right thing to do. I'd rather not have surgery unless absolutely necessary though.

Any insight is appreciated.

sunnyaz
Posts: 582
Joined: Oct 2010

Hi TX Diva,

"The cytologic differential diagnosis includes nodular goiter and follicular neoplasm." This has me a bit confused. A "neoplasm" is cancer of the follicular variant. Are you sure they said it was benign? Are you sure the Nurse Assistant knew what she was reading? The fact that you were exposed to radiation is another concern along with your symptoms leading up to the biopsy. What exactly were your symptoms and how long did they persist?

Blessings,
Julie-SunnyAZ

TX Diva
Posts: 4
Joined: Jul 2011

This is why I'm so very confused. I accidently left off of my post the "Microscopic Examination" section of the Path report. It reads, "See diagnosis and comment. No cytologically malignant cells are identified".
The person who initially called me with results said, "Your tests results were negative so just keep your appointment in two weeks and talk to the doctor about course of treatment." which I did. But I didn't get to see the doctor, rather I saw the Nurse. The nurse said no cancer as well so simply monitor.

Symptoms have been going on for well over a year....Hair loss, dry skin, weight gain, swelling in ankles/feet, extreme fatigue, dry eyes (so much so that I can't even blink on occasion), trouble swallowing. I can't lose weight for anything. I walk/run 5-6 miles per week and intake a healthy amount of calories. Weight just keeps coming on. It's to the point now that I have a difficult time breathing when I run. Gasping and wheezing.

I didn't even key on thyroid until I was discussing my symptoms (mainly hair loss) with my hair stylist during an appointment last fall and one of her co-workers told me she had thyroid problems and I just described every one her symptoms. Went to GP doc and he ran blood work. Levels all normal. I insisted something was wrong. He did thyroid ultrasound. That's when we found nodules.

Another thing I forgot to mention is that my first Ultrasound last December showed the larger nodule at 2.0 cm. The ultrasound in March showed it 2.3 cm and the nurse at Endo said no big deal because it was probably the difference in Ultrasound techs and the way they held the probe during the test. I'm not a tech so I don't know if there is truth to that or not.

I called Endo yesterday and asked for THE DOCTOR to call me to discuss my results. That was in the morning. Here we are 24 hours later and still no call. I'm seriously considering a call to MD Anderson since I'm only a 2 hour drive from there. I just don't know if I'm jumping the gun or not.

Thanks so much for your reply, sunnyaz!!

3boys_mom
Posts: 47
Joined: Jun 2011

Yes, ultra sound is an art as well as a science. I am curious what lab work they did to determine that you are "normal". Do you have a copy of your lab reports? If they are just going by TSH then you very well could be suffering from thyroid problems and still have a "normal" TSH level.

MD Anderson is where I am going on July 20. They do dx thyroid issues, so if you are able to go, it might be worth it. Your doctors office is certainly contradicting themselves.

Sarah

Baldy's picture
Baldy
Posts: 226
Joined: Mar 2011

According to wiki, a "neoplasm" may be benign, pre-cancerous or cancerous.

Alan

mhc4165
Posts: 46
Joined: Dec 2008

A neoplasm doesn't mean it's cancer,the majority are benign follicular neoplasms.

 

Here is a link to a January 2013 PubMed article  called, Oncocytic Follicular Nodules Of The Thyroid With Or Without Chronic Lymphocytic Thyrroiditis:An Institutional Experience by many doctors all at University of Penn and two of them  are top thyroid cytopathologists I sopke to,DR.Virgina Livolsi and Dr.Zubair Baloch who both called me back. Dr.Baloch gave me my second opinion on my then benign FNA results of all 3 of my thyroid nodules in July 2008 a month after another endo who isn't at university of Penn,did my first FNA . And they found that 79% of these follicular neoplasms with oncocytic features,after surgical follow up out of 269 cases,were benign.

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