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hurthle cells found but told everything is ok?

Peachiemom's picture
Posts: 3
Joined: Jun 2011

Hello my name is Linda. In 2005 I had a hemi-thyroidectomy. In the pathology report it states that things like-hyperplastic coloid nodules, grossly encapsulated nodule micro and macrofollicular change with cholesterol granuloma formation. In some areas Hurthle cells change has been seen with cytologic atypia. Dystrophic calcification is present withi the wall and in one of the sections a group of well circumscribed bodies. The features are seenwhich appearalmost lamellated. The features are those of a follicular lesion with some hurthle cell transforamtion. In some areas the follicular nuclei shows nuclear grooves however definite cytoplasmic clearing cannot be demonstrated. It is not felt possible to sustaniate a diagnosis of fallicular carcinoma. The diaognosis is felt more likely to be a Hurthle cell leasion and some of the changes are secondary to repeat aspiration biopsies over he past eighteen months.

I continue to get alrasounds every 6 months to keep and eye on the left lobe remaining tha also contains lumps and goiters. I also recieved radiation therapy as a child for acne.
I was told in 2005 afterhemi-thyroidectomy that everything was ok and never told about any of these finding on pathology report. When I had asked my GP for a copy of the pathology report(on the phone)in 2005 he said...rambling off a lot of things listed in the report and asked if I knew what any of those things where. I replied no I didn't, he said neither did he and that I did not need this report. Last week I saw the surgeon as I do every six months and asked him for the pathology report...he said rather defensively "do you think I am lying to you?". I told him that I didn't think he was lying, that I have all of my reports except that one. He did give me this report.

Sorry for such a long story.

My question is are they lying to me? Do I have something I should be concerned with this report? If anyone can give me some answers I would love to hear them.
Sincerely Peachiemom.

Posts: 507
Joined: Apr 2010

Hi Linda

I spent a few min looking at the report before I decided I would need to translate it to understand it.

There are a lot of terms they used let’s see if I can put some English in that doctor speak.

hemi-Thyroidectomy - so you still have 1/2 your thyroid. are you on any thyroid replacement or is your 1/2 thyroid doing enough.

-----cut - http://en.wikipedia.org/wiki/Hyperplasia - no I’m not ashamed of using Wikipedia sometimes it has the best quick answer.
Hyperplasia (or "hypergenesis") means increase in number of cells/proliferation of cells. It may result in the gross enlargement of an organ and the term is sometimes mixed with benign neoplasia/ benign tumor.

Hyperplasia is a common preneoplastic response to stimulus. Microscopically cells resemble normal cells but are increased in numbers. Sometimes cells may also be increased in size (hypertrofia).
Hyperplasia is different from hypertrophy in that the adaptive cell change in hypertrophy is an increase in cell size, whereas hyperplasia involves an increase in the number of cells.

------- cut-- http://www.medicalonly.com/2007/06/21/thyroid_growths

Colloid nodules. These benign growths are responsible for most cases of thyroid nodules. Colloid nodules occur when the thyroid, for reasons that are often unknown, begins to generate extra tissue that is non-cancerous. These growths are often undetectable without the use of advanced imaging techniques.
So far so good...
Some of these terms are hard for me to find good websites or info on since most the info is for thyroid cancer pathology and hard to separate non cancer ones from it

Grossly encapsulated nodule micro and macro follicular -- umm ok follicular cells in the goiter or node the word grossly is in reference to the size

Encapsulated: Confined to a specific area; the tumor remains in a compact form

--- cut- http://brainsurgery.upmc.com/conditions-and-treatments/cholesterol-granuloma.aspx
Cholesterol granulomas are rare, benign cysts that can occur at the tip of the petrous apex, a part of the skull that is next to the middle ear. The cysts are expanding masses that contain fluids, lipids, and cholesterol crystals surrounded by a fibrous lining.

Granulomas can occur throughout the body as a reaction to foreign material. They usually have no symptoms or serious effects. However, cholesterol granulomas of the petrous apex are dangerous because of their proximity to the ear and several important nerves. Permanent hearing loss, nerve damage, and bone destruction can occur if the mass is left untreated and continues to expand.

Cholesterol granulomas can form when the air cells in the petrous apex are obstructed. The obstruction creates a vacuum that causes blood to be drawn into the air cells. As red blood cells break down, cholesterol in the hemoglobin is released. The immune system reacts to the cholesterol as a foreign body, producing an inflammatory response. Associated small blood vessels rupture as a result of the inflammation. Recurrent hemorrhaging makes the mass expand.

The surgical approach depends on the location of the cyst and the status of the patient's hearing. At UPMC, the preferred surgical approach for cholesterol granulomas is the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. EEA offers the benefits of no incisions to heal, no disfigurement to the patient, and a faster recovery time.

Does not seem to me to be part of the thyroid diagnosis but...

Man I wish they just used English in these reports...

cytologic atypia - is a sub classification and does not seem to have a reference leaning to cancer or non cancerous.

---- cut -http://en.wikipedia.org/wiki/Dystrophic_calcification -
Dystrophic Calcification (D.C.) is the calcification occurring in degenerated or necrotic tissue, as in hyalinized scars, degenerated foci in leiomyomas, and caseous nodules. This occurs as a reaction to tissue damage,[1] including as a consequence of medical device implantation. Dystrophic calcification can occur even if the amount of calcium in the blood is not elevated. (A systemic mineral imbalance would elevate calcium levels in the blood and all tissues and cause metastatic calcification.) Basophilic calcium salt deposits aggregate, first in the mitochondria, and progressively throughout the cell. These calcifications are an indication of previous microscopic cell injury

Ok basically from what I can read of the report I do not see anything that points to cancer but as the doctor told you they want to see you for more biopsies as time goes by so they can keep an eye on it.

I am no doctor but I cannot find anything that shouts out to me.

I would ask the doctor if he can translate the report to English and since he has the knowledge he should be able to get every word...

Unfortunately it is hard for people to translate the reports because of the language they use.

Most people I have seen here have called it a "lobectomy on the right side of the thyroid" instead of a "hemi-Thyroidectomy"

the best line in your report is "is not felt possible to substantiate a diagnosis of follicular carcinoma" in other words they could not diagnose follicular cancer.

I would be concerned about your thyroid hormone levels since you only have 1/2 a thyroid ... did the report say anything about parathyroid I ask this because people often miss this as a separate organ that sometimes gets removed as well cause it cannot be separated from the thyroid

I have had 2 of my 4 parathyroid’s removed when they took out my thyroid.

Please ask any more questions you can come up with and we will try to answer them.


Peachiemom's picture
Posts: 3
Joined: Jun 2011

Thank you Craig for your help. There are two reports as the first guy felt he needed another look. I have been very curious about this report due to my health problems. I have been sick way oo long. I am not on any medications for my thyroid or otherwise. I was given tapazol to treat hyperactive thyroid but has a terrible reaction and had nevver had hives so large. At pressent my blod work say my cratinine is elevated along with LKC, lymps and basophils. I have had these elevations for a few years now and the numbes keep climbing higher. I have multinodular structures in the left lobe. I am not wanting surgery why didn't they take it all?
sincerely Linda

Baldy's picture
Posts: 243
Joined: Mar 2011

Hi Linda,

Hurthle cells are rarely an indication of cancer.

From wiki ...

"A Hürthle cell is a cell in the thyroid that is often associated with Hashimoto's thyroiditis as well as follicular thyroid cancer."

"Clinical significance: A Hürthle cell adenoma is a type of thyroid benign tumor that, in RARE CASES, has the potential to become malignant and metastasize (Hürthle cell carcinoma). Hürthle cells are also found in Hashimoto's thyroiditis and toxic and nontoxic nodular goiter. Hürthle cells are hypothesized to be of follicular epithelial origin."

Both quotes are from ...
I supplied the caps "RARE CASES" in the second quote.


Peachiemom's picture
Posts: 3
Joined: Jun 2011

Thank you Alan for the links and information. I had been a bit freaked out about this really.


Baldy's picture
Posts: 243
Joined: Mar 2011

Hi Linda,

Freaked is normal. I think we've all been riding the anxious-reassured roller coaster :)


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