# Can anyone help with FNA results; Would you still be worried?



## gadamscctx (Jul 10, 2010)

FNA Report:

Microscopic Description:

Aspirate smears show a moderate amount of colloid material with a hemorrhagic background that contains neutrophils and occasional histiocytes. There are a few small collections of Cbenign appearing follicle cells that appear quantitativly adequate (approximately 6 groups of 10 follicle cells). No significant cytologic atypia is seen. The cell block section showed degenerated hemorrhagic material with histiocytes and colloid.

Diagnosis:

BENIGN FOLLICULAR NODULE C/W COLLOID NODULE

Comment: Clinical follow-up is indicated since benign thyroid aspirate maybe associated with a false/negative of up to 5%.

Doctor wants me to come back in January to let her do an ultrasound to see if there have been any changes. I was just concered with the follicular reference since I have read that with follicular they cannot distinguish between benign or malignant with FNA.

Thank you for your time and opinion.

Gerry


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## Andros (Aug 26, 2009)

gadamscctx said:


> FNA Report:
> 
> Microscopic Description:
> 
> ...


Yowza, Gerry. You know I agree with you that there remains an area of concern. You read correctly.

Unlike papillary thyroid cancer, it can be difficult to diagnose without performing surgery because there are no characteristic changes in the way the thyroid cells look. Rather, the only way to tell if a follicular or Hurthle cell nodule (or neoplasm) is a cancer, is to look at the entire capsule around the nodule and see if there is any sign of invasion. A fine needle aspiration (FNA) biopsy usually cannot distinguish between follicular adenoma (the precursor to follicular cancer), follicular cancer and a completely benign condition called nontoxic nodular goiter. Even a coarse needle biopsy, which is typically more accurate than an FNA, cannot always provide an answer since it is only able to differentiate between a follicular neoplasm (which includes both adenoma and cancer) versus nontoxic nodular goiter about 40% of the time. These biopsies can only look at individual cells and not the entire capsule. This difficulty in diagnosis is one of the most frustrating areas for physicians who study thyroid disease, because it means that surgery is often the only way of definitively diagnosing a thyroid nodule. Patients with a follicular or Hurthle cell neoplasm typically require removal of half of the thyroid gland, called a diagnostic lobectomy. We call this procedure a "diagnostic lobectomy" because we are trying to make a definitive diagnosis by removing the thyroid lobe. The pathologist then looks at the entire capsule around the nodule to see if there is a follicular or Hurthle cell cancer. This elaborate inspection can sometimes take up to a week to perform. Depending on the individual patient and his or her risk factors, up to 80% of patients undergoing diagnostic lobectomy will have a benign nodule and not require further therapy. Unless we definitely know a nodule is a thyroid cancer during the operation or there are nodules in the opposite lobe, we will only remove one half of the thyroid gland, since removing both sides of the thyroid gland is associated with increased complications and there is a good chance you would not need to take thyroid hormone if you have one side of your thyroid remaining. If there is a cancer, the patient will require removal of the other half of the thyroid in an operation called a "completion thyroidectomy."

Full article here..........

http://www.cumc.columbia.edu/dept/thyroid/follicular.html


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## gadamscctx (Jul 10, 2010)

Thank you, Andros for answering me,again. I still am concerned, but I am not sure if at this point I am going to get any of the doctors I am seeing now to do anything more. I am still going to try, and the page you sent was great! I am printing it out and some others I found to show to Dr. Megna next time I see Him.

I really don't mean to keep asking the same thing over. I guess with the FNA report I was hoping maybe someone would see something in it, that I didn't, or don't know about.

Thanks again,

Gerry


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## CareBear3030 (Jun 9, 2010)

Living without a vital organ is a big step to take. My cancer is/was papillary, so I had no choice about it all, and it was a definate diagnosis. I certainly feel for you and your need to wait to know. January is not that far off for this slow growing cancer... but, through my journey the wait is the part that that was agony for me. Hang in there, try to take it easy, and if possible, put this out of your mind for a month or two. I'll keep you in my prayers and please keep us posted!


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## Andros (Aug 26, 2009)

gadamscctx said:


> Thank you, Andros for answering me,again. I still am concerned, but I am not sure if at this point I am going to get any of the doctors I am seeing now to do anything more. I am still going to try, and the page you sent was great! I am printing it out and some others I found to show to Dr. Megna next time I see Him.
> 
> I really don't mean to keep asking the same thing over. I guess with the FNA report I was hoping maybe someone would see something in it, that I didn't, or don't know about.
> 
> ...


You can ask over and over and over............I don't mind a bit.

The thing about FNA is that the material is confined to only a certain area most notably a nodule that is big enough to aspirate. In my mind, that in no way covers the whole gland.


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