# Had FNA 9/13 Now have questions



## dbartlett (Sep 15, 2012)

Hi. I had an FNA 9/13 for 2 left lobe nodules. Original US showed 1.9cm and 1.6cm nodules that were complex, increased vascularity, internal necrosis, small internal calcification, hypoechoic. Right lobe had 5mm nodule and small cyst.
The FNA was scheduled for 45 minutes to 1 hours. It lasted over 2 hours! At first the doctor couldn't find the second nodule in the left. I told her I brought the original cd of my US with me. After looking at that she finally found it. Was very close to 2nd nodule and may be merging together. There was a dr. in training along with the dr. who was to do the FNA. The dr. in training started the biopsies but kept coming up with just blood, no tissue. Finally the full fledged dr. took over. Had that needle 13 times! Preliminary results of nodule 2: follicular lesion of undetermined significance. No prelim of nodule 1.

I asked the dr. to just look at the right side to see if the nodule had grown since the US (July 31). She told me not only did I have the one nodule and one cyst, I had several nodules (she counted at least 4) and told me she saw the parathyroid which was "concerning". She refused to tell me what she meant by that.

I have several symptoms: pain when swallowing, tenderness in the front of my neck, hurts to yawn, can't raise my voice or sing because I lose it, frequent choking, voice goes hoarse.

My PCP will get the final path report this week. Dr. who did the FNA said that if the results were "undetermined" that she would recommend repeat US and FNA in 3 months. Are you kidding me? With all the issues I have? Not in my book, at least that's what I'm thinking now.

My plan is to get an appointment with an ENT close to home as soon as possible. The funny thing is, I went to what I thought was the best hospital in the state where I live. Now I'm not so sure about that.

My thyroid levels are in the normal range, but not where they should be.
TSH: 1.41 range 0.46-4.68
Free T4 0.87 range 0.58-1.74

Any thoughts or suggestions? I had to wait 6 weeks to get the appointment for the FNA and don't want to wait that long again.


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## webster2 (May 19, 2011)

I agree, get an appointment with an ENT. Hang in there!


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## crimebuff (May 25, 2012)

dbartlett said:


> Hi. I had an FNA 9/13 for 2 left lobe nodules. Original US showed 1.9cm and 1.6cm nodules that were complex, increased vascularity, internal necrosis, small internal calcification, hypoechoic. Right lobe had 5mm nodule and small cyst.
> The FNA was scheduled for 45 minutes to 1 hours. It lasted over 2 hours! At first the doctor couldn't find the second nodule in the left. I told her I brought the original cd of my US with me. After looking at that she finally found it. Was very close to 2nd nodule and may be merging together. There was a dr. in training along with the dr. who was to do the FNA. The dr. in training started the biopsies but kept coming up with just blood, no tissue. Finally the full fledged dr. took over. Had that needle 13 times! Preliminary results of nodule 2: follicular lesion of undetermined significance. No prelim of nodule 1.
> 
> I asked the dr. to just look at the right side to see if the nodule had grown since the US (July 31). She told me not only did I have the one nodule and one cyst, I had several nodules (she counted at least 4) and told me she saw the parathyroid which was "concerning". She refused to tell me what she meant by that.
> ...


When a FNA biopsy comes back indeterminate, there is a new test which will help decide whether its likely malignant or not. In the past when you got an indeterminate result, the doctors advised surgery. This is the Afirma Gene Expression test by Veracyte labs. My FNA came back indeterminate on a nodule that I had tested by FNA 8 years ago-benign result then Just watched it and it never grew-had FNA again lasy year again with the indeterminate, AFFIRMA TEST SAID MORE THAN 50% chance of cancer, had the surgery and lo and behold it was cancer. With your symptoms, I wouldn't wait.


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## Andros (Aug 26, 2009)

dbartlett said:


> Hi. I had an FNA 9/13 for 2 left lobe nodules. Original US showed 1.9cm and 1.6cm nodules that were complex, increased vascularity, internal necrosis, small internal calcification, hypoechoic. Right lobe had 5mm nodule and small cyst.
> The FNA was scheduled for 45 minutes to 1 hours. It lasted over 2 hours! At first the doctor couldn't find the second nodule in the left. I told her I brought the original cd of my US with me. After looking at that she finally found it. Was very close to 2nd nodule and may be merging together. There was a dr. in training along with the dr. who was to do the FNA. The dr. in training started the biopsies but kept coming up with just blood, no tissue. Finally the full fledged dr. took over. Had that needle 13 times! Preliminary results of nodule 2: follicular lesion of undetermined significance. No prelim of nodule 1.
> 
> I asked the dr. to just look at the right side to see if the nodule had grown since the US (July 31). She told me not only did I have the one nodule and one cyst, I had several nodules (she counted at least 4) and told me she saw the parathyroid which was "concerning". She refused to tell me what she meant by that.
> ...


Oh...................that has to come out. Follow through on your plan. What does your Thyroglobulin and Thyrogobulin Ab look like?

Your clinical symptoms do strongly suggest cancer.

Thyroid cancer symptoms
http://www.medicinenet.com/script/main/art.asp?articlekey=53303

http://www.cityofhope.org/patient_care/treatments/thyroid-cancer/Pages/symptoms.aspx


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## CindiG (May 9, 2013)

crimebuff said:


> When a FNA biopsy comes back indeterminate, there is a new test which will help decide whether its likely malignant or not. In the past when you got an indeterminate result, the doctors advised surgery. This is the Afirma Gene Expression test by Veracyte labs. My FNA came back indeterminate on a nodule that I had tested by FNA 8 years ago-benign result then Just watched it and it never grew-had FNA again lasy year again with the indeterminate, AFFIRMA TEST SAID MORE THAN 50% chance of cancer, had the surgery and lo and behold it was cancer. With your symptoms, I wouldn't wait.


I have a lot of great important articles by many different endocrinologists written at different times for The American Thyroid Association's journal criticizing the Afirma test and how 48% (I'm sure it's much higher!) they misclassify benign nodules as suspicious! I would really like to post the articles on here but I don't know if the moderators will allow me to.

The other day I spoke to Barbara Rath Smith the executive director of The American Thyroid Association and she said she was going to email articles as files to download and she did. I asked her if I have permission to email and post these articles and she said yes,they are for the public.

A woman on the excellent health site Medhelp told me she had a 3cm. something nodule with a majority of Hurthle cells with normal thyroid blood tests and the Afirma test came back more than 40% suspicious so she had half her thyroid out and this nodule was benign! I also read on this Inspire site in their Thyroid Cancer Survivors Association forum,a woman had a 2cm indterminate nodule that everyone was concerned about and her Afirma test came out suspicious,and she had her thyroid removed,it turns out that the 2cm nodule was benign but they found tiny papillary cancers all under 5mm that weren't even seen on the ultrasound! She also said that her surgeon told her he's had five patients that had a suspicious result from the Afirma test,and then when their nodules were removed and tested they too were benign!

Yesterday endocrinologist Dr.Steven P.Hadak who co-authored one of these studies called me back and was very nice,he even had a patient waiting! He said this Afirma test is wrong half the time misclassifying benign nodules as suspicious,(I'm sure it's even more than half!) and I said this is not a good test,and he said I don't think it's a good test either!

Please click on this link,for some reason I can't cut and paste out the forum discussion. I just found *another* woman on this very board with a 1-1 and half cm solid hypoechoic nodule who had an inconclusive Fine Needle biopsy which was suspicious as a follicular neoplasm and mine is being called a follicular neoplasm with oncocytic (hurthle cell features) ,this woman had her FNA nodule sample tested by the veractye Afirma Test which is what I had done,the results came back telling her that her that their results on her FNA was highly suspicious and that because of this her endo told her she had an 80% chance of having thyroid cancer and so she had her thyroid out and found out it was benign!

http://www.thyroidboards.com/showthread.php?t=5283


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