# Hurthle cell changes now/graves and I131 23 years ago



## Miss Mouse (Jun 2, 2011)

Hello, I am asking for any additional information possible about my results. I have to wait 2 weeks to see the surgeon and I have a few questions. 
First the facts - 46 year old female. Diagnosed with graves disease when I was 23. After one year of medication therapy I had two rounds of I 131. hypo now. 
I was having more trouble than usual this year during allergy season, throat swelled up from coughing etc. and felt like I was choking on flem more than I should be - went horse and lost my voice. Pills getting stuck in throat. When I swallowed you could see my thyroid went to one side. It caught my eye in the mirror, thats why I was alerted in the first place.
I may add that when allergies went away, symptoms have almost gone away. Endo said I may have acid reflux, causing the sensation in my throat. Hummm I wonder, she may be right about that. But good I went in anyway.

Trip to eno sent me to ultrasound. came back with 2 nodules. One 2cm round mixed soft and cystic mass, the other 2.1x.8x1.0cm solid. Blood flow seen in both.Then Endo did Needle biopsy. this is where it get complicated!:confused0006:
She only biopsied the mixed - so I have no idea about the solid.

Path report states-_ ...prep. show a cellular aspirate composed of variably sized follicles. Hurthle cell changes are present and there are some scant chronic inflammatory cells seen. Colloid material is sparse but present. The background shows numerous macrophages and acellular debris. The differential diagnosis include Hash thyroiditis or a degenerating adanomatiod nodule, which is favored. However, a follicular neoplastic process cannot be completely ruled out. Consider repeat biopsy or clinical intervention to further evaluate this lesion. The associated risk of malignancy as defined by the Bethesda is 5 -15%._

I have looked up the Hurthle cell changes and that is confusing. Because I have graves and have had the radiation (23years ago, which it is also said to be bad - over 20 years after I131 cancer can rear its ugly head), this could account for the presence of these Hurthle cells. Or it could be undergoing malignant transformation.
Soooooo the big question is- *does anyone have any experience with 
graves/ I131 and nodules with Hurthle cell changes? *
I find a lot of information on all these things but no hints on what the chances are.
Anyone? Many thanks ahead of time!:hugs:


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## lainey (Aug 26, 2010)

Mmm, I would find an endocrine surgeon, or a surgeon that specializes in biopsies for cancer (breast or otherwise) and have both nodules sampled again.

The pathologist needs to know that the thyroid was ablated over 20 years ago (unless they did this time?). That would influence their "differential diagnosis" I would think.


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## Miss Mouse (Jun 2, 2011)

Thank you for replying. I have no indication that patho knows about previous ablation, or even that I have graves. I think you are right, it seems that would make a difference. seems a bit like blind leading the blind doesn't it?
I am scheduled with the chief of surgery in a large hospital. He is a general surgeon, but he is the one that does most of the thyroids. I did ask Endo about that. I just can't believe my dr. Only biopsied the complex nodule. I am more anxious about the solid one and I guess I will have to wait. I am guessing they will suggest to take them both out? Would you agree? I wasn't worried until I read about the hurtle cell mess! I have also had three benign tumors in breast removed over the span of 19 years on separate occasions. Not sure how that plays into it if at all. I also am a repeat offender in the iron deficiency anemia dept. I was full blown amemic 7 years ago and did the tablets that took a painfully long time to correct. After that I have had 2 rounds of ten of iron infusions over the past 4 years. I also have bottomed out in my vit D twice. The first time was so bad my bones seriously ached very bad! They have done about every test to find the "leak" to no avail. So I just have to keep having iron infusions about every 18 months or so. I am on my way down fast now in iron and figure I will need another one in about three months or so. I am concerned about surgery taking place when I am low, but not dead like they want you to be before the give you treatment! I wonder if repeated iron and vit. D def. are somehow related? I won't know till I see surgeon. Meanwhile any words of wisdom are greatly appreciated! Thank you for patience with long post. Hard to sum up everything and can't list it all either! Ahhhh! Lol! Big sigh.......


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## Miss Mouse (Jun 2, 2011)

Hello !
I wanted to post a reply even if so short - I am super busy and cant find time to post a proper ending to my story. Feel free to ask if you have any questions.
BUT I want to say I am SOOO happy I had the nodules removed! I am like a new person! They were poisoning me!!! The surgery / recovery wasn't a walk in the park but I am so thankful to have my life back! Anyone sitting on the fence about if they should have removed... I say " Move that bus!!!" and get them the heck out! 
I did not have cancer thankfully, so my nightmare is OVER!:tongue0015:
I wish all of you the best of luck and take care!


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## Lovlkn (Dec 20, 2009)

Miss Mouse,

So glad you came back to update!

I did not see your posts in 2011 and when I read this post I was thinking surgical removal was your best bet.

Glad to hear it worked out for you.


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## webster2 (May 19, 2011)

Me too! I am so glad you feel better and have a happy ending. I had Hurthle cells too but it didn't matter because they were evicted along with the other muck makers! Thank you for the update!


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