# hashi's and nodules - any reason to keep thyroid?



## rosequartz (Jul 11, 2010)

I have elevated antibodies for hashis, therefore hashi's.
I had 1/2 my thyroid and the isthmus out 5 years ago due to nodules. there were hurthle cells in the FNA, but the pathology showed it was benign. Now I have 3 big nodules on the other side, all over 1 cm. Is there any reason to do another FNA because I'm thinking it will have to come out anyway. What would be a good reason to keep it in?


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## Andros (Aug 26, 2009)

rosequartz said:


> I have elevated antibodies for hashis, therefore hashi's.
> I had 1/2 my thyroid and the isthmus out 5 years ago due to nodules. there were hurthle cells in the FNA, but the pathology showed it was benign. Now I have 3 big nodules on the other side, all over 1 cm. Is there any reason to do another FNA because I'm thinking it will have to come out anyway. What would be a good reason to keep it in?


Hi there!! I assume the Hurthle cells were the ones indigenous to Hashimoto's easily identifiable by a trained pathologist? I ask because some Hurthle cells are recognizable as cancer. I assume you mean benign for cancer?

What has your doctor suggested? FNA?


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## rosequartz (Jul 11, 2010)

thanks for replying....I don't know if they were hashi's hurtle cells, or regular hurthle cell.....I didn't know there were more than one kind. All i know is they said it's got hurtle cells, we won't know for sure if it's cancer until we take it out. My understanding is that it was benign because it was encapsulated. What if it broke free of the capsule....then would it become malignant?
I haven't been to the ENT yet, I wanted to go armed with my thyroid u.s. and blood test results. But I want to be informed before I go. So is there any good reason to hang onto a thyroid with nodules when you have hashi's?
I'm wondering if he will want to do a FNA, but why bother if there's no good reason to keep the thyroid
btw they didn't say I had hashi's 5 years ago, they didn't even say it this time......I determined it by requesting a TPO antibodies test and the results were over 100


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## Andros (Aug 26, 2009)

rosequartz said:


> thanks for replying....I don't know if they were hashi's hurtle cells, or regular hurthle cell.....I didn't know there were more than one kind. All i know is they said it's got hurtle cells, we won't know for sure if it's cancer until we take it out. My understanding is that it was benign because it was encapsulated. What if it broke free of the capsule....then would it become malignant?
> I haven't been to the ENT yet, I wanted to go armed with my thyroid u.s. and blood test results. But I want to be informed before I go. So is there any good reason to hang onto a thyroid with nodules when you have hashi's?
> I'm wondering if he will want to do a FNA, but why bother if there's no good reason to keep the thyroid
> btw they didn't say I had hashi's 5 years ago, they didn't even say it this time......I determined it by requesting a TPO antibodies test and the results were over 100


While high TPO is "suggestive" of Hashimoto's, as far as I know it is not definitive. Only the Hurthle cells described above are if they are present at pathology.

I am glad I asked you those questions then. You see the conundrum here? Because of the uncertainty; I personally would want it yanked. I can't tell you how many times individuals have had the gland out and were shocked to find that they had cancer even though they were assured they did not.

If that is the case and the ENT agrees; certainly don't waste time, money and anguish with FNA.

The above is my humble opinion only.


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## rosequartz (Jul 11, 2010)

ok we're kinda thinking the same way here....
but why do you say high TPO antibodies are only "suggestive" of hashi's
I heard that if they are over 100, that proves you have hashi's


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## Andros (Aug 26, 2009)

rosequartz said:


> ok we're kinda thinking the same way here....
> but why do you say high TPO antibodies are only "suggestive" of hashi's
> I heard that if they are over 100, that proves you have hashi's


http://www.thyroidmanager.org/Chapter8/8-frame.htm

Scroll down to Diagnosis. Read carefully. You will note the words "suggestive" and "suspected" are used frequently. Implying further testing should be done if you really want to know for sure and I know I would.

Scroll down to Figure 7.

http://www.thyroidmanager.org/Chapter6a/chapter6d.html

http://www.ncbi.nlm.nih.gov/pubmed/19623156

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


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## CA-Lynn (Apr 29, 2010)

With respect to TPO antibody test it should also be noted that:

Tests positive for 95% of Hashimoto's patients
Tests positive for 50-85% of Graves patients

Low levels can be detected in normal euthyroid patients

So best to get the full gamut of antibody tests to confirm.


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