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Confusing thyroid FNA

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Old 07-20-2012, 09:26 PM   #1
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tgrace70 HB User
Question Confusing thyroid FNA

Hello! My family doctor found a thyroid nodule on examination 4 years ago. An initial thyroid ultrasound guided fna was performed at that time, along with a T133 scan, showing a cold nodule that measured 1.1cm x .7cm. The lab report read:

" No atypical cells see, aspirate consists of abundant colloid, sheets of uniform follicular cells arranged in a honeycomb pattern and scattered foamy and pigmented macrophages. The features are consistent with a nodular goiter."

I went for my annual check up with my Endocrinologist last month who advised that the nodule has grown "significantly", measuring at 2.1cm x 3cm and scheduled a repeat fna, performed without US guidance, which read:

Descriptive Diagnosis: "Groups of follicular cells with prominent hurthle cell change and abundant colloid, consistent with a hyperplastic nodule"
General Catergorization:"Benign"

(These results are from different laboratories)

Both my endocrinologist and the surgeon have advised me to have a total thyroidectomy, and have labeled this as a Hurthle Cell Neoplasm. I agreed to surgery and set a date for next week, July 25th. Only after these appointments did I actually receive the cytology report, which reads to me that this is a benign process. I am a little nervous about having the surgery, especially now that I have read the path report that states the nodule is benign.

Any thoughts or suggestions would be welcome!! Thanks!

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Old 07-23-2012, 09:11 AM   #2
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Re: Confusing thyroid FNA

I'm sorry I don't know more about the subject to advise you further, but this will bump your question to the top of the list for someone who knows more [hopefully Reece] to see.

This much I think I know... The FNA sample may be benign, but the presence of Hurthle cells is what made your doctors advise thyroidectomy.
"We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln

Old 07-23-2012, 02:17 PM   #3
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Re: Confusing thyroid FNA

An fna only gets a sample of cells, it's not diagnostic in itself, just a tool that you combine with other tools (ultrasound) to determine if you should have surgery---only removal of the lobe actually gives you a diagnosis for sure.

The "hurthle cell change" was one red flag (the cells are mutating) as well as the fact that this has grown---and grown quite large. Sometimes, even though these are benign, they grow out of control, and can wrap themselves around the structures in your neck.

I think the surgery is a good idea, but you should be with a surgeon that explains things to you, and gives you confidence, and is very experienced doing many thyroid surgeries per week, you don't have to rush, you can go to get another opinion or two in the meantime.

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