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Old 04-16-2008, 04:06 PM   #1
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Biopsy results question?!?

Hey guys I let you guys know that my biopsy was benign a few weeks ago, just had the follow up w/ endo yesterday and I asked for a copy of results.

Its says The smears show clusters of follicular epithelial cells w/ extensive hurthle cell change in a background of lymphoid infiltrate at various stages of maturation and no significant degenerative changes or colloid substance.
Diagnosis: Findings are consistent w/ Hashimotos Thyroiditis.

He says we follow up w/ US in a year then maybe rebiopsy it then we'll see.
Is this the right approach do you guys think?!?!?!?

 
Old 04-16-2008, 04:35 PM   #2
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Re: Biopsy results question?!?

UGH! Well welcome Hashi's sister. Standard treatment of nodules are US every six months. My ENT is on top of thyroid care and he sets routine six month US guided FNAs up.. he does the FNA if the nodule has changed size. He also has one come in if you notice a change or sudden growth. These growths can change quickly depending on your antibody activity. I like him because he has done surgery for sinus mess on me twice and my son once. Recoveries were great. My last ultrasound was January. My thyroid has grown and now I am having swallowing issues. I have two more weeks and then I can be sure that it is not the new meds. Then I will call up and get in. i am not waiting til the end of June with this recent growth.

MG
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Old 04-16-2008, 05:30 PM   #3
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Re: Biopsy results question?!?

Thanks MKG for responding, do you think that the "hurthle cells" are a cause for concern? My endo says no, but everything on this board regarding those type of cells is negative. Just like some input. thanks!

 
Old 04-16-2008, 06:25 PM   #4
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Re: Biopsy results question?!?

From the Journal Article:"The meaning and predictivity of Hürthle cells in fine needle aspiration cytology for thyroid nodular disease." European Journal of Surgical Oncology , Volume 30 , Issue 7 , Pages 786 - 789; Authors: P. Kauffmann , C. Dejax , M. de Latour , J. Dauplat

This research study investigates the significance of Hürthle cells in thyroid nodule fine needle aspiration cytology (FNAC) and what they predict. This study looked at 110 patients with Hürthle cells in FNAC. The study followed the patients for many years and noted the subsequent trends.
The following results were determined:
1) The density of Hürthle cells in FNACs ranged from 20 to 100%.
2) 89 out of 110 had benign nodular disease (Hürthle cell or follicular adenoma) 80%.
3) 20% of patients had malignant tumours. So statistics favor benign growth.
4) The presence of more than 50% Hürthle cells in FNAC correlated with benign or malignant Hürthle cell neoplasm.
5) Hürthle cell carcinomas displayed more than 90% Hürthle cells in FNAC, the more dense the packing the higher the chance that you have a carcinoma.

Now this is just one of the more recent larger group studies. So when you get the report.. look and see if they note disperse or dense clusters. I am inferring that the hurtle cells were dispersed throughout from the blurb in your original post.

Hope this helps. I now know a bit more about FNA results.

MG
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Old 04-17-2008, 04:04 AM   #5
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Re: Biopsy results question?!?

Thanks again mkg, the report doesnt say dense or disperse. Just extensive hurthle cell change, thanks

 
Old 04-17-2008, 05:35 AM   #6
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Re: Biopsy results question?!?

I personally would see an ENT/surgeon. A surgeon that takes these nodules out regularly, knows from his/her own experience what an fna like that means to him/her from that experience, and I would trust that opinion as a second (or third) opinion.

The reader in the lab definitely considers this benign, and that's a good thing. But this definitely must be watched more closely----I would want another ultrasound in 6 months, and if it grew, I would consider removing it.

 
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