# Confused about what endo said after biopsy



## sjde (May 6, 2010)

My biopsy showed lots of Hurthle cells so I will be having surgery. Haven't had the consult with the surgeon yet.
The endocrinologist told me there's an 80% chance it is benign. But the pathology report says "moderate suspicion of carcinoma." To me, 20% is not moderate .

Also, the endocrinologist said if I get in to see the surgeon within 4-6 weeks, it should be fine. Worst case scenario--if it is malignant, it's a slow-growing one. But online, I've seen it labeled aggressive.

Can anyone shed light on this? Thanks.

Sue


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## hillaryedrn (Dec 14, 2009)

Take a deep breath. It will be ok! Try not to read too much online about it. It isn't imperitave that you have surgery TOMORROW, but I wouldn't wait 4-6 weeks. Yes, chances are it is benign, but don't let it sit forever. There isn't much known about Hurthle Cell carcinomas. However, even if it is an agressive carcinoma, not much is going to happen in a couple of weeks. I would just go ahead and make your appointment with the surgeon and explain to him/her your concerns. Most surgeons are very understanding. I had Hurthle Cell changes in my tumors, so I feel your concern!


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## Andros (Aug 26, 2009)

sjde said:


> My biopsy showed lots of Hurthle cells so I will be having surgery. Haven't had the consult with the surgeon yet.
> The endocrinologist told me there's an 80% chance it is benign. But the pathology report says "moderate suspicion of carcinoma." To me, 20% is not moderate .
> 
> Also, the endocrinologist said if I get in to see the surgeon within 4-6 weeks, it should be fine. Worst case scenario--if it is malignant, it's a slow-growing one. But online, I've seen it labeled aggressive.
> ...


Sue; you are so so fortunate they found them and identified them. Thank goodness for that part.

Yes to the surgery. I hate this for you but ultimately you are going to come out like a champion.

Here is info but please bear in mind that nothing is definitive until they yank it out (just joking around) and send it out to pathology. Then you will know and it will be for the most part behind you except for possibly some radiation treatments.

Hurthle cell neoplasm 
FNA specimens of Hürthle cell lesions (benign and malignant) usually show:• Cellular aspirate comprising a single cell population of Hürthle cell in a background of minimal colloid. Cells can be arranged in monolayer sheets, follicular groups or as scattered single cells [87]. Some authors have suggested that cellular dispersion leading to single cells is more common in aspirates of Hurthle cell carcinoma than adenoma; however, this observation has not been validated [87]. Cellular atypia is also commonly observed in Hurthle cell lesion; this can be seen in the form of random nuclear enlargement, multi-nucleation, cellular pleomorphism and prominent nucleoli.• FNA specimens of neoplastic Hurthle cell lesions may show intra-cytoplasmic lumens and transgressing vessels [88].

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2365970/

And here is another good abstract on Hurthle Cells..........

http://www.ispub.com/journal/the_in...se_report_and_short_review_of_literature.html

We are here for you. I am keeping you in my thoughts and prayers.


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## sjde (May 6, 2010)

Thank you both. I have a sister and sister-in-law with hashi's and nodules , and their endocrinlogists never suggested FNA. But I think mine did say it was because he saw calcification and a good blood supply. The nodule is less than 1 cm. 
The doctor told me Hurthle cells are not unusual in people with hashi's but in my case there were lots and they were very active.

I have heard some surgeons will send tissue to pathology while you are on the table so if malignant they can remove the entire thyroid then and not have you come back. But isn't it true that those quick pathology reports aren't that accurate?

Sue


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## Andros (Aug 26, 2009)

sjde said:


> Thank you both. I have a sister and sister-in-law with hashi's and nodules , and their endocrinlogists never suggested FNA. But I think mine did say it was because he saw calcification and a good blood supply. The nodule is less than 1 cm.
> The doctor told me Hurthle cells are not unusual in people with hashi's but in my case there were lots and they were very active.
> 
> I have heard some surgeons will send tissue to pathology while you are on the table so if malignant they can remove the entire thyroid then and not have you come back. But isn't it true that those quick pathology reports aren't that accurate?
> ...


Sue; there are different kinds of Hurthle cells. Some are indigenous to Hashimoto's and some are indigenous to cancer. That is why a very very good pathologist is gold. They must have a lot of experience.


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## sjde (May 6, 2010)

I have read something different--that it's not the presence of these cells that makes them it cancer, it's if the cells have broken through the capsule around the nodule and invaded thyroid tissue. Otherwise it's considered a benign Hurtle cell tumor (or adenoma or neoplasm--I'm not sure of the correct terminolgy).


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