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  • Mocha232....question On Hurthle Cells!!

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    Old 02-12-2007, 12:57 PM   #1
    Jenny C.
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    Mocha232....question On Hurthle Cells!!

    Quote:
    Originally Posted by mocha232 View Post
    I'm 27 and have a "hurthle cell neoplasm" (tumor). It's 2.5cm and I'm having a TT this friday. Hurthe cells are very difficult to diagnose and it is impossible to determine malignancy via FNA. The only way to determine malignancy is to have the thyroid removed and checked for "vascular invasion" (invasion of the surrounding blood vessels). You need to have the whole thyroid removed because hurthle cells tend to spread quickly and there is a higher risk of cancer compared to papillary *****. These types of cells are very rare and it's difficult to get info on them that isn't written in medical jargon. Just know that your surgeon will advise that you have the thyroid removed and if he doesn't, then tell him you want it removed. I believe that if hurthle cells are not malignant now, they will be in the future, all it takes is time.

    Just know, there are lots of people who have had this surgery and they came through with flying colors. In the end, you'll do great and you won't have to deal with it anymore.

    Hi Mocha,

    Good Luck with your surgery on Friday ...I just read your post..I was wondering, on the literature you have read about Hurthle cells...It is very TRUE..it is VERY HARD to find literature about it, on this internet..God knows, I have searched and searched, and it is VERY LITTLE INFO, I have found.
    Anyways, I had a Hurtle cell Tumor removed...back in November, mine was the same size as yours..2.5 cm...I am sure you read my post, so I won't repeat myself too much ...but my surgeon had missed on the FNA, that Hurthle cells were present, prior to surgery...so he ONLY removed my right lobe...then he found out AFTER surgery, that the biospy report, showed Hurthle cells.
    My question is...IS it SAFE to still have my remaining left lobe??? Do you think on any information, you have read, that it can still be in there??
    It scares me, that it could spread to the left side...He said, it didn't invade my surrounding tissue, or my blood vessels...so I should be OK...but he will monitor me with sonograms every 6 months.
    Have you found any research stating, that it can indeed be on the left side, microscopically.
    I am thinking I should call him, and just have him remove my left side...It is scarey.
    Any info you have learned, and want to share would be GREATLY APPRECIATED!!

     
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    Old 02-13-2007, 12:26 AM   #2
    mocha232
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    Re: Mocha232....question On Hurthle Cells!!

    Hi Jenny,

    I know how worried you are regarding the other half of your thyroid. The info I've read suggests that if the hurthle cells haven't invaded the surrounding blood vessels, that the other side "should" be okay. However, the treatment for a hurthle cell finding is somewhat controversial. Generally, the entire thyroid should be removed. I believe you said your Doc stated that if he had seen the hurthle cell findings to begin with, he would have removed the whole thing. I believe that statement speaks for itself. If I were you, I would have the other side removed for peace of mind. I don't believe that hurthle cells can be monitored. They can only see if the other side is growing or showing signs of possible cancer, but not necessarily hurthle cell. My first biopsy was nondiagnostic and the second one a year later showed over 75% hurthle cells. The question I have is: were they there the whole time and the FNA didn't pick them up the first time as my nodule was 1.2cm at the time.

    Continued below...

     
    Old 02-13-2007, 12:34 AM   #3
    mocha232
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    Re: Mocha232....question On Hurthle Cells!!

    The real question would be: do you have any other nodules in the remaining half? If you do, I would have it removed and be done with the whole thing. My ENT gave me the option of removing half for now. I asked him the reasons for keeping the other half as well as what the chances were that I would get to keep the other half. He told me that most patients like to keep half so they won't need meds, since thyroid meds are so hard to stabilize on. He then told me that if I didn't care about taking meds then there was no reason to try and keep half. He also told me that there was an 80% chance the other side would come out in the next 5 years.

    Hurthle cells are in and of themselves cancer cells but aren't deemed malignant until they have invaded the surrounding blood vessels. Yours showed no invasion so there shouldn't be a problem. It's really about what YOU want to do. If you're worried, then remove it. Taking one little pill everyday beats worrying and going through testing for the rest of your life. Cont...

     
    Old 02-13-2007, 12:45 AM   #4
    mocha232
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    Re: Mocha232....question On Hurthle Cells!!

    I'm sorry that this is so long winded

    What did your final path report say? My ENT is going to do a frozen section during the op, but finding follicular or hurthle cell cancer is rarely done that way. But he did say that if he didn't like the look of it when he opens me up, he will take the whole thing out then and there. So I decided to do the TT, which he agreed was the wiser course of action. Was yours an incidental finding of hurthle cells or was it a full blown tumor? Here is the results of my second biopsy:

    Comment:
    The sample contains macrophages, abundant colloid, and fragments of follicular epithelium predominantly arranged in a honeycomb pattern and exhibiting varying degrees of hurthle cell change. Some hurthle cell groups exhibit mild nuclear pleomorphism and atypia. Stromal fragments are noted. The features suggest a hyperplastic nodule that has undergone cystic change and that exhibits hurthle cell metaplasia. The differential diagnosis includes a hurthle cell neoplasm.

    Scary huh?

     
    Old 02-13-2007, 05:26 AM   #5
    Jenny C.
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    Re: Mocha232....question On Hurthle Cells!!

    Thank You Mocha SOOO VERY MUCH!!! I knew from reading your post, that you were very knowledgable.
    Yes, your report is VERY SCARY.

    With me....Mine was real sudden...Never knew I had ANY thyroid issues, before I found a "lump" on my neck.
    Found out through CT scan and Ultrasound, that I had a Nodule...that was 2.5 cm in size, on my right lobe.
    They did the FNA, and ALL my Dr, told me, was it was BENIGN, and he told me...that he would recommend just to watch it for 6 months, but then he told me..that the FNA, isn't always 100% accurate on saying "FOR SURE" it is Benign..IT COULD STILL BE CANCER, but a slim chance.
    Well needless to say...I opted for surgery, because I wanted to rule out Cancer 100%...and surgery was the ONLY way of knowing 100%.
    Well yes, when they did the surgery...they did the frozen section, like you had talked about, and he said, "AT that time, they thought it was just Follicular Lesion...SO then he sewed me back up...because the Original plan was IF they suspected ANYTHING, then they would REMOVE the whole thyroid.
    Well then, 4 hours AFTER I woke up...He came to me, and said, that he was VERY UPSET, because NOW, the Pathologist, was saying he thought it was a Pappillary tumor, and he explained all of that, and said, for me NOT TO PANIC, but now with the Pathologist saying this...there was a 1 in 5 chance it was cancer..but he said we just had to wait to see what the FINAL Pathologist report stated, and go from there...

    Well here is the FINAL REPORT:
    Part 1: Lymph Node, Delphian, Excision Benign Lymph Node, and Portion of Benign thyroid tissue.
    Part 2: Thyroid, Right Lobe and Isthmus, Lobectomy and Ischiectomy
    A. Mild Nodular Hyperplasia with Dominant Hyperplastic Oncocytic (Hurthle Cell) Nodule, with Secondary Degenerative Cystic changes.


    So Now after that, he told me, IT DIDN'T invade my blood vessels, and as far as removing the left lobe, he would just watch me.."FOR NOW"...with sonograms every 6 months...and IF any nodules form, he will remove the left lobe.
    So that is where we are.
    I am currently on levothyroxine now, since my left lobe didn't compensate for my right lobe being gone.
    But I am scared that it could still be in there...I personally would have preferred the whole thyroid out.
    You made me FEEL ALOT better, knowing...that it isn't mandatory to remove the whole thyroid with Hurthle cells.
    I have to go see him in May, so I am going to ask him, if he will take the remaining lobe.
    THANK YOU SOO MUCH for all of your advice...I have searched this internet OVER AND OVER again, and could hardly find anything on the Oncocytic word, and the Hurthle cell...SO your knowledge is SOOOO REASSURING...THANK YOU!!
    If you know anymore INFORMATION, about the words in my Pathologist report, PLEASE FEEL FREE TO SHARE.
    GOOD LUCK TO YOU ON FRIDAY, I WILL BE PRAYING FOR YOU!!
    Please let me know, how you are doing and feeling, once you feel well enough to sign back online.
    THANK YOU AGAIN...I REALLY APPRECIATE YOU TAKING THE TIME, TO SHARE THE KNOWLEDGE YOU HAVE LEARNED!
    Jenny

    Last edited by Jenny C.; 02-13-2007 at 05:30 AM.

     
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    Old 02-14-2007, 12:31 AM   #6
    mocha232
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    Smile Re: Mocha232....question On Hurthle Cells!!

    You are VERY welcome, and THANK YOU for the well wishing for Friday. I can't wait to get this thing out of me.

    I'm so glad that you feel better about the whole thing. It looks like your nodule exhibited a few of the same features that mine has: hyperplastic (oncocytic = hurthle cell) nodule with cystic change. It's a good thing you got it out when you did. The hurthle cells are scary as it is, but when the nodule starts exhibiting cystic change it could get much worse. My understanding is that if hurthle cells aren't malignant now, they will be at some point in the future. Make sure they let you know exactly what is found during your U/S so that you know. If a new nodule appears or gets bigger, you know what to do. I'm glad you'll be talking with your Doc in May about removing the other lobe. I think that it's the right thing to do. None of us need this kind of worry on top of life's other problems.

    Anytime you have a ?, just ask. The info is so hard to find and I'm happy to share what I know.

    Cheers!

     
    Old 02-16-2007, 10:47 AM   #7
    tdooders1
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    Re: Mocha232....question On Hurthle Cells!!

    Hi. I had surgery November 2 2006. I had my isthmus removed because it had a 2" nodule on it. I didnt have a biopsy before surgery because my ENT doctor said there was no point because it had to come out anyways. So he took it out and left the right and left lobes of my thyroid. After surgery I was told he took out two lymp nodes also because they were enlarged. He did a frozen biopsy during surgery. It was benign. I had to wait a week after surgery to get the results of my nodule which was benign but had hurthle cells which were also benign. But from doing all the reading here it is suggested I shouldve had my entire thryoid out. I go back to my doctor in two weeks for follow up on blood work. (am on synthroid now). Should I ask him about the hurthle cells to see if the rest of my thyroid should be taken out or am I just worrying over nothing.

     
    Old 02-16-2007, 12:23 PM   #8
    Jenny C.
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    Re: Mocha232....question On Hurthle Cells!!

    Quote:
    Originally Posted by tdooders1 View Post
    Hi. I had surgery November 2 2006. I had my isthmus removed because it had a 2" nodule on it. I didnt have a biopsy before surgery because my ENT doctor said there was no point because it had to come out anyways. So he took it out and left the right and left lobes of my thyroid. After surgery I was told he took out two lymp nodes also because they were enlarged. He did a frozen biopsy during surgery. It was benign. I had to wait a week after surgery to get the results of my nodule which was benign but had hurthle cells which were also benign. But from doing all the reading here it is suggested I shouldve had my entire thryoid out. I go back to my doctor in two weeks for follow up on blood work. (am on synthroid now). Should I ask him about the hurthle cells to see if the rest of my thyroid should be taken out or am I just worrying over nothing.
    Hi tdooders,

    YES, I would definitely ask him, and PLEASE let me know what he says..
    Good Luck!!

    Jenny

     
    Old 09-22-2007, 05:34 PM   #9
    louie112
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    Re: Mocha232....question On Hurthle Cells!!

    Hi,
    My FNB said that the stroma surrounding the thyroid follicles reveals focal lymphocytic infiltrate. Does this mean the Hurtle cell metaplasia has spread into y lymph nodes? WHat does Clinical correlation is recommended mean

     
    Old 09-23-2007, 01:49 PM   #10
    Jenny C.
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    Re: Mocha232....question On Hurthle Cells!!

    Hi Louie,

    I don't know what your report means...I wish I could be of more help.
    It has been a year this coming November, since I had my right side removed and it was a Hurthle cell...So far, My left side, is FINE...My doctor feels I don't need to get that half out, unless nodules form, and as of know, I have no nodules, that I am aware of, on my left side.
    I wish you the best of luck, and please know you will be OK...It is SOO SCARY, that was a very scary time in my life, SO I know EXACTLY what you are feeling right now.....but I am OK...and it has been almost a year.
    So please know, surgery is a breeze, and you too will be OK.
    There is alot of wisdom and great advice on this board, and most of all wonderful people who offer alot of support.
    They really helped me through a hard time.
    Please let me know, what your Dr. says on Monday.
    I will be praying for you, that God gives you peace, and just know, when you go in to surgery...God is there with you, cast all your fears on him, and HE will give you the strength you need to get through it.
    Keep me posted!


    Jenny

    Last edited by Jenny C.; 09-23-2007 at 01:51 PM.

     
    Old 09-30-2007, 03:18 PM   #11
    louie112
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    Re: Mocha232....question On Hurthle Cells!!

    Hi,
    I guess I am ust freaking out a bit here. I can not get into and endo until the 24 of october and I dont like the thought of this ting growing inside of me. Does anyone here know of and endo dr. in Michigan? I am not usually freaking like this bu this time I am worried.

     
    Old 10-04-2007, 12:49 PM   #12
    Jenny C.
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    Re: Mocha232....question On Hurthle Cells!!

    Hi Louie,

    I am soo sorry, that you are soo upset...I UNDERSTAND your anxiety FULLY.
    They say that these kinds of nodules grow slowly..I think you should do just fine, waiting until the 24th..However, in the meantime, keep looking for another endro in your area...and if you can get in somewhere sooner, then I would definitely go..Just to calm your nerves down.
    I remember, a year ago, when I was going through exactly what you are going through right now..I wanted mine out ASAP..SO I know how scared you are.
    From the time I found out about my nodule, I found out in September, and had my surgery in November...so I honestly think you will be ok to wait...but by all means, IF you find somewhere sooner, then go.
    Sorry, I am now just checking my posts...I haven't been online in a week.
    Please know everything will be OK...try to relax, and if you have to vent or have any questions at all...Please feel free to re-post...and I can try to help you out.
    Good Luck and please keep me posted!
    Jenny

     
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