# Just had FNA



## Suburban (Jun 12, 2011)

Hi,

Just got back from having another ultrasound and an FNA done (finally!).

The ultrasound person was a bit short with me when I asked for a copy of the results to be sent to me. In the end she told me that I had a few large nodules on the left side with the largest measuring about 1.5 cm by 2.5 cm. This is a bit of a size difference from the last ultrasound I had back in June when the largest was 1.5 cm by 1.3 cm. I'm wondering if its grown or if the previous ultrasound missed it?

They had to do the FNA twice in order to get enough cells - the second time really hurt as the needle went pretty deep! Now my thyroid is rather swollen and it hurts to swallow and cough. I've just took some painkillers so hopefully that will help.

The surgeon said it was all looking benign and that the calcification I have is macro not micro which is good.

I am hoping to get the results this coming Wednesday when I have an appointment with the endocrinologist again. Then I get to see the surgeon again in a few weeks time to discuss treatment - if any.

The surgeon has told me to act as if its benign to think about whether I want surgery anyway.

I really don't know about this as my all levels are within range, albeit some of them on the low end of normal.

The largest nodule I have seems to be a bit big amongst some other large ones but I don't know if that's enough to warrant surgery. But there's also the fact the FNA can't give 100% accuracy.

Sorry for all the rambling on! Any feedback is really welcome! Thanks.


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## Andros (Aug 26, 2009)

Suburban said:


> Hi,
> 
> Just got back from having another ultrasound and an FNA done (finally!).
> 
> ...


Nothing like confusing the patient with several opposing comments. Anyway....................get out the ice, my dear friend and ice that neck down. You will feel so much better if you do!

We will just have to wait for the FNA. Sending hugs and prayers your way!










I just found this. The only difference I can see is the size differentation. Anything solid or calcified is suspicious.

Calcification was assessed in respect to its size and was classified as microcalcification (when there were tiny, punctate echogenic foci of 1 mm or less either with or without posterior shadowing), macrocalcification (when punctate echogenic foci were larger than 1 mm in size), or rim calcification (when a nodule had a peripheral curvilinear or egg-shell calcification). 
http://radiology.rsna.org/content/247/3/762.full

The statistically significant features for the depiction of a malignant nodule were a taller-than-wide shape, a spiculated margin, marked hypoechogenicity, hypoechogenicity, microcalcification, and macrocalcification (Figs 4-7). Despite statistical significance, etc..

(Same link as above!)

I really did not think that made a whole lot of sense what your doctor told you.


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## Suburban (Jun 12, 2011)

Thanks Andros for the hugs and good vibes!

Yeah fingers crossed for the report!


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## I DClaire (Jul 31, 2011)

Suburban said:


> Hi,
> 
> They had to do the FNA twice in order to get enough cells - the second time really hurt as the needle went pretty deep! Now my thyroid is rather swollen and it hurts to swallow and cough. I've just took some painkillers so hopefully that will help.
> 
> ...


I wonder about two things you've mentioned and I feel like I've thought about with my own decision:

1. Why won't physicians do something, even put a person to sleep briefly, to do a FNA? We all get knocked-out for tests like colonoscopy, endoscopy, etc. Some people talk like they endure the procedure O.K. but many also report it being painful.

Is there some reason the patient cannot be sedated? I know another thyroid patient online who was totally knocked-out for a biopsy at a prestigious nationally recognized medical center but my endocrinologist absolutely wouldn't hear of it.

I feel like my doctor was disappointed that I opted out of FNA but I can't see putting myself through that (I'm woefully traumatized by needles) when apparently the results aren't totally dependable.

2. _I don't know how to word this._ Can or do people who know they have nodules live normal lives with those nodules OR does the time eventually come when they must be removed? If repeated ultrasound indicates old nodules are growing and new nodules are developing, is delaying surgery necessarily going to mean the procedure will become more complicated in the future OR with repeated FNA, can someone continue on indefinitely and maybe the nodules eventually self-destruct?

3. I have a male cousin whose one and only nodule was diagnosed by a cardiologist, he was immediately referred to a surgeon and had the nodule removed. That was probably 15 years ago and he reports he never had anymore trouble. He is 6' 2", works hard every day, but said when he had the one nodule he got so weak and fatigued he thought he was having heart problems. After surgery he never even needed medication.

If surgery was always done that quickly (and I've read about minimally invasive thyroid surgery), could a patient have a reasonable hope that more nodules wouldn't develop?


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## Suburban (Jun 12, 2011)

Hi I DClaire,

I suppose they don't like to routinely knock people out for the FNA procedure as anaesthesia is not without its risks. But if you have a phobia of needles then perhaps it should be an option? Or perhaps they could give some sort of temporary tranquilizer?

Regarding your point no.2 I too think about this which is why its hard for me to make a decision regarding surgery. One doc did say to me that if I got to 60 years old and still hadn't had surgery then he would recommend it before the risks got higher. I think once the nodules get so big they probably aren't going away on their own - unless they are true cysts that might break up etc (bear in mind I'm no expert on this!).

I think that if you leave part of the thyroid and just take out one lobe then nodules can still develop. If you have a total thyroidectomy then you are definately going to need be medication for the rest of your life as you can't do without it. That's a big thing for me to consider in whether to have surgery or not - I'm not on any meds at the moment.


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## Suburban (Jun 12, 2011)

Got my results - they say 'benign' arty0045: Yay!

I know that FNA isn't 100% accurate but I'm going to go with it for now. I see the surgeon in a couple of weeks and I'm going to tell him I don't want surgery at the moment as long as I can have regular ultrasounds and perhaps a biopsy once a year to follow up.


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## joplin1975 (Jul 21, 2011)

YAY!!!!!!!!!!!!

Congrats!!


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## Christinals (Sep 9, 2010)

congrats!!!!!


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## Andros (Aug 26, 2009)

Suburban said:


> Got my results - they say 'benign' arty0045: Yay!
> 
> I know that FNA isn't 100% accurate but I'm going to go with it for now. I see the surgeon in a couple of weeks and I'm going to tell him I don't want surgery at the moment as long as I can have regular ultrasounds and perhaps a biopsy once a year to follow up.


What truly wonderful news!! Good for you! Let us know the game plan now re meds or whatever.


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## webster2 (May 19, 2011)

I am very happy for you!


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## murphy749 (Aug 25, 2011)

Awesome news . So happy for you. hugs6


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## Suburban (Jun 12, 2011)

Thanks everyone! arty0009:

Andros - I'm not going to be on any meds as my levels are still within range. Just going to work on being fit and healthy as much as possible now.


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## Suburban (Jun 12, 2011)

Hi,
Haven't been on here for a while as I needed a break from worrying about my situation. I went to see the surgeon today and have made a decision - for now - not to have surgery as it seems my thyroid is of the benign kind. I know the FNA can't be 100% certain but I am happy to live with the benign result for now.

I feel lucky that the surgeon is a people person and was interested in my wellbeing as well as what might be happening medically. We have agreed I will see him in six months for another ultrasound and then review - I feel totally happy about this and feel that someone is finally treating my properly! If anyone wants to know of a good surgeon in England please PM and I will give the details!

We discussed the biopsy and ultrasound results and it may be that I have the beginnings of Hashimotos as I have thyroiditis. Looking up the symptoms it does seem I fit some of them. Will have to see how things progress but it could apparently account for the up and down levels of my TSH and perhaps the rising antibodies.


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## webster2 (May 19, 2011)

I am so glad you finally got some medical attention with a good doctor, at last! Also, am glad you are in a good place about all things thyroid too!  Thanks for letting us know!


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