# need help with pathology report



## nini08 (Apr 20, 2011)

I have multi bilateral heterogeneous glandular echotexture with multiple hyperchoic nodules. The fna report said focal hurthle cell change is apparent on left side and on the right side it just said occasional cells exhibit hurthle cell change. the final comment says it suggest a benign/reactive process. Not so sure I feel comfortable with the wording suggest.... Please Help me, I do have Hashi's.


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## usmc4myson (Sep 26, 2010)

Well, that's a mouthful! I don't like the fact that you have a focal Hurthle cell change, and yet, they think it is a benign/reactive process. That seems to me like a contradiction of terms. If you are not comfortable with the wording on the report, than I would suggest that you trust your gut, and at the very least, ask for clarification. I always google stuff like that too...sometimes another medical site will add more clarity to the haziness of the terminology.

I have a bone to pick with many radiology reports that I have gotten over the years that do not contain enough information. There should be a gold standard for what information MUST be included in a report, and patients should be able to request any missing information easily. Why is it that doctors never really question the radiology reports? My 15 yo son was injured in wrestling. He had inconclusive xrays. Then the orthopedic surgeon ordered an MRI. The MRI came back "normal." However, when my surgeon looked at the actual films, she saw the bilateral L5 S1 fractures right away, and proceeded to point them out to me! My son was having numbness and tingling on the outside of his foot, his calf, and thigh!! Thank God the doctor didn't take the radiology report as set in stone! However, most doctors don't know much about reading a scan, and trust that the radiologist is truly paying attention! I was wondering if they were reading a good book while attempting to read my son's MRI at the same time!!

I hope you find some clarity and peace...until then...hang in there. Someone who knows way more than me will surely offer their input soon.

~Amy


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## Andros (Aug 26, 2009)

nini08 said:


> I have multi bilateral heterogeneous glandular echotexture with multiple hyperchoic nodules. The fna report said focal hurthle cell change is apparent on left side and on the right side it just said occasional cells exhibit hurthle cell change. the final comment says it suggest a benign/reactive process. Not so sure I feel comfortable with the wording suggest.... Please Help me, I do have Hashi's.


What you need to find out from your doctor or the pathologist is are the Hurthle cells indigenous to Hashimoto's or are they indigenous to cancer. Sad but true. There are both kinds.

Can you do that; give them a call?

Typically, benign thyroid nodules appear hyperechoic on the sonogram, while malignant (cancerous) thyroid nodules are more likely to be hypoechoic, casting off fewer or weaker echoes. However, the chance of any hypoechoic nodule being cancerous is still very low, because benign thyroid nodules are much more common. If a thyroid nodule requires further evaluation, the next step is generally to perform a fine needle aspiration (FNA) of the suspicious nodule, a test in which a thin needle is inserted into the nodule to extract cells for evaluation. Looking at these cells under a microscope helps to determine whether or not the nodule contains cancer cells.

Bottom line: You should speak with your doctor about your thyroid ultrasound results and ask whether the findings require further evaluation by a test such as an FNA
http://www.everydayhealth.com/specialists/cancer/hensley/qa/what-are-hypoechoic-nodules/index.aspx

Let us know.










I use the word suggest a lot and you should be uncomfortable with that word. It has a specific meaning as you well know. Good for you!


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