# Confused by FNA (biopsy) Report



## silenced-whisper (Feb 4, 2015)

Today I picked up a copy of my FNA (biopsy) report for a solid nodule measuring 2.8 x 2.1 x 1.9 cm and I am confused by parts of it. My report stated...

Final Diagnosis:

Left Thyroid, Biopsy, and Touch Imprints - Hurthle Cell Lesion with Prominent Lymphoid Proliferation (See Comment)

Comment:

The differential diagnoses include Hashimoto's Thyroiditis and Hurthle Cell Hyperplasia in a nodular goiter. Clinical Correlation and follow up studies are recommended as clinically indicated.

So, I understand that the findings verify that I have Hashimoto's but what I need help understanding is what exactly Hurthle Cell Hyperplasia is and what is meant by Prominent Lymphoid Proliferation. Most importantly I want to know what both of these mean as far as implications for my thyroid and overall health.

I also have 2 nodules on the right side of my thyroid measuring 1.5 x 1.5 x 0.81 cm (consistency not stated) and 2.0 x 1.6 x 1.5 cm (solid) and I am wondering if these should have been or should now be biopsied too.

Thank you so much or taking the time to read this, I am really grateful for any clarification the community here can give.

P.S. Not sure if it helps to clarify any of the above but also in the pathology report, under Microscopic Description, it states...

A. Sections reveal multiple core biopsies showing prominent lymphoid infiltrate. In a few cores, there are remnant small follicles lined by Hurthle cells. There is intervening fibrosis.

B. Examination of eight touch imprint slides reveals follicular cells singly dispersed into sheets. No classical intranuclear inclusions or grooves identified. Few follicular cells show Hurthle cell change. Skeletal muscle fragments are identified in the background with thin colloid.


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## Andros (Aug 26, 2009)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228061/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228061/

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis
(Copy and paste into your browser)

Hashimoto's Hurthle cells
http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)71549-2
(Copy and paste into your browser)

http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/
(Copy and paste into your browser)

http://www.mayoclinic.com/health/hurthle-cell-cancer/DS00660

It is possible to have Hurthle Cells indigenous to Hashimoto's and have Hurthle Cells indigenous to cancer.

It may be best to have your thyroid ablated. What has your doctor suggested?

Bless your heart! Let us know how you fare!

Hugs,


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## joplin1975 (Jul 21, 2011)

Both the hurthle cell stuff and lymphoid proliferation are words I've seen to describe cellular changes related to Hashi's.

Unless you see the word malignancy, it usually doesn't change much related to health, other than continued need for thyroid meds to suppress TSH and keep Hashi's "simmered down."


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## silenced-whisper (Feb 4, 2015)

Thank you both for your warm and informative responses.

I have not yet gotten a response from my doctors. I had my biopsy last Monday and the results were in and sent to both my doctors on Wednesday. On Friday I went to the Medical Records department at the hospital to get a copy of the results for my own records, but as I stated before they left me a bit confused. I am now frustrated that after several calls I still have not had a response from either of my doctors regarding the results of my biopsy.

So, from you and a bit of my own research, I understand a little more about Hurthle cells but I am still confused by what "Prominent Lymphoid Proliferation" and "Lymphoid Infiltrate" mean.

I am just tired of waiting, wondering and guessing.


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## breetlee6666 (Feb 23, 2015)

I was looking into thyroid hormone levels, but had saw lectures by a Dr Mark Gordon who mentioned previous head trauma's can give rise to hormonal imbalance, and thus my exact symptoms; bedridden etc.


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