Can you request a second opinion on FNA slides?

[wysewoman]

Hello,

I've just read this article: ncbi.nlm.nih.gov/pubmed/211...

Having just had two Thy1 (inconclusive) and one 3a (some atypical cells) I'm wondering whether its worth requesting another pathologist to have a look. My endo doesn't seem to want me to have any more FNA's and is suggesting a hemithyroidectomy. The atypical cellswere follicular ones but for whatever reason there were not enough(??) / didn't display the right characteristics(??) to be placed in the 3f category.

Or maybe FNA slides are routinely reviewed by two people? Does anyone know?

Thanks,

Melissa

[LouiseRoberts]

Sorry you had no replies - hopefully someone with relevant knowledge will pick this up from latest activity..

L

x

[tilly83]

I'm not sure but given how worried you must be I would - take someone with you and write notes..... these can make up legal documents should the need ever arise and medical staff usually react better if they see you do this x

[mowgli72]

I had a FNA done for a 2.5cm nodule. Scan read that all was benign . I got told the cells from the FNA also were showing benign but because they were follicular it was like 'poking a needle into an orange' and it couldn't be proven that all cells were benign until the nodule was removed and they could thoroughly check. I had half thyroidectomy and results came back benign. It is such a scary road and I understand your worry completely. A year down the line I am having more issues and awaiting ENT. Its horrid and the worry of the unknown is not nice. I hope you get answers soon . X

[wysewoman]

Thanks to those who replied.

Mowgli - I hadn't heard that description before so I guess it does seem to make sense that I have a hemithyroidectomy. However why the hell don't they just start off from that point of view !! I find it unbelievable that even with your thy2 benign result they still recommended a hemi! In the last 6 months I've had 3 FNA, several trips to the consultant and blood tests. Every time the cycle of anxiety is so stressful and I don't handle stress too well :(. All I know is that my bloods are normal and that one result said I have some atypical cells !! It seems I've found out so little for all that stress !

Good luck with your issues and I hope you get some resolution soon. Btw did you have to take any medication after your hemi ? My endo said about 10% of people do.

I am now trying to mentally think myself into accepting that I will have a hemi. I guess even a benign nodule is likely to grow so it sort of boils down to visible lump or visible scar and possibly medication. - what a choice !

Melissa x

[Clutter]

My lump was very visible but my scar is not. It was reopened for completion after Hurthle cell carcinoma was discovered too.

I wasn't given medication inbetween hemi and completion as the remaining lobe was expected to pick up the slack of the hemi. I don't think it did, but I also had Hashimoto's and this may have been having it's own party and interfering.

Post completion the lobe histology was clear of cancer. I've had a lot of difficulty adjusting to levothyroxine so often regretted the loss of the healthy lobe. On the other hand, I would probably have ascribed the symptoms I was experiencing to a recurrence of cancer &/or the Hashi's so it's probably just as well I went ahead.

Ensuring your ferritin, vitD3, B12 and folate are not deficient and are high in range will help your post op recovery and adjustment whether on thyroxine or not.

Surgery for me was almost painless and I took very few of the generous amounts of painkillers available in hospital (overnight) and taken home.

[wysewoman in reply to Clutter]

Thanks for that Clutter. You seem to have a very reasonable and balanced viewpoint about these things - which is really useful for me at the minute as I'm still in the throes of anxiety following my appointment yesterday !

As for the supplements you mention - is there any particular brand of vitamins that you took or were they and are they usually prescribed by the hospital ? It sounds like there is some good practical advice here and I shall definitely look into getting those supplements before I have the hemi.

Thanks!

Melissa

[Clutter in reply to wysewoman]

It's taken me 2 years to get from a very bad place to here and I didn't have to make the decision you need to make.

GP and hospital will only prescribe vitamins if you test deficient. Low in range is good enough for them but NOT for hypothyroid patients. Don't be fobbed off with "your FBC is ok so your vitD etc will be fine." My FBC was good but my vitD was <10, folate deficient and B12 low. Ideally you will be tested but, if not, it is safe to self supplement.

Your calcium will be checked after your hemi in case it drops, which is quite common and it usually rights itself after a few days.

I take 2,000iu daily VitD3 (prescription), 1000mg vitC, 300mg magnesium, 15mg zinc all Asda, 1200mcg spray BetterBoostB12 (methylcobalamin), 100mg each of Solgar B1, B2 & B6 every other day from Amazon (use the click through affiliate code to benefit TUK).

If you can't be faffed you could take a good quality multi-vitamin or two but I was advised to take the above as I'd been so ill and run down. I'm definitely feeling the benefit, too.