FNA Result: Atypical

[sakura20]

Hi! I am new to this site and this is my first post. I chanced upon this site when I was googling for info on thyroid nodules. Early this year, I went to this hospital for check up and to get prescription for my hypertension. Upon meeting my new doctor, she asked if I have goiter. I said I don't think so. She said she thinks I have goiter as she noticed something in my neck. She then requested for a blood test and results came back normal, so she asked me to have an ultrasound. I'm so thankful to her, she was the one who noticed it. She's a blessing to me. My family and my friends and even me have not noticed before that I have nodule. My previous doctor has not even noticed it.

4cm solid nodule was found at the left side of my thyroid. FNAC was done last month. I was so nervous and worried. I got the result yesterday after anxiously waiting for a month, but still no definite result if my nodule is benign or malignant.

Diagnosis:

Left thyroid nodule FNA: Atypical ; Follicular lesion of undetermined significance.

Repeat FNA will be done after 3 months.

Has anyone here had this result before? Is it high risk?

I'm so nervous and worried. I may need to undergo a surgery if the repeat FNA will show the same result. Sigh :(.

I'm getting depressed with no one to talk to who have the same experience.

[shaws]

Someone who has had the same/similar diagnosis to you will respond.

One very good thing is that your doctor obviously took a good overall look at you, something most doctors don't appear to do nowadays.

I am sure everything will go well for you.

Best wishes

[sakura20 in reply to shaws]

Thank you so much shaws for taking your time to reply. Praying that everything will go well for me.

I'm so glad I found a caring doctor like her who takes care of her patients very well. I have only seen her a few times but she remembers me very well. She's indeed a blessing to me.

[shaws in reply to sakura20]

It does make a huge difference when you are listened too and being compassionate is a great virtue especially for doctors. Unfortunately it has been lost by many.

Best wishes.

[loopyboo]

Hi there! Please don't get anxious I'm sure everything will be fine. I too have nodules on my thyroid which were also spotted by my dr when I went to see him about a funny sensation I had on the other side of my neck to where the actual nodules are?? He actually said he thinks I have a goitre and sent me for a scan which showed nidules on my right side then I was referred to another hospital to see endo who sent me for another scan and a fna which also came back undermined and intermediate risk. The hospital have decided to do a partial thyroidectomy( not sure if spelt right) I'm still waiting for apt date.

I'm no expert by far and I'm sure you will get some great response on here but if they are rescanning you soon and doing another fna then maybe they think there's no risk etc. although you could ask to get a second opinion about it re having an operation to remove it to be on the safe side?

I hope you get a good response and some questions answered to help out your mind at rest. I too am quite anxious but am trying to trust in the nhs.

Take care

Lou xxx

[sakura20 in reply to loopyboo]

Thank you so much Lou for your reply. It feels comforting to communicate with someone who is also in a similar situation. It feels depressing if there's no one to talk to who can understand what we are going through. Anyways, I feel much better now. I shouldn't worry to much. I'm glad I found this community.

In your case, decision is to have an operation instead of repeating the FNA, maybe because removing it is much safer than waiting again for another FNA to be done.

I hope everything will go well in your operation. Will be praying for you.

Sakura

[Ritaritarita in reply to sakura20]

I understand honey. Don't feel alone, the girls here are lifesavers. Bless them x

[sakura20 in reply to Ritaritarita]

Thank you Rita. So true.

[Churchie]

Hi Sakura

Yes I have had the same result. Back in April my GP noticed my goitre (clearly visable ) and like you I was shocked that I or none of my family noticed. Just goes to show you don't notice what you are not looking for.

I had an FNA on 22 sept and the result was atypical grade 3a. I saw a thyroid surgeon yesterday who told me that the protocol for a lump of my size (4.6x3x2.2cm) was to remove the affected half side of the thyroid. However I am very concerned to lose half of thyroid and be reliant on synthetic thyroxine which I had a very bad reaction to. Due to this information she agreed that the best way forward was to repeat the biopsy and take larger samples the next time to try to establish definitively whether the nodule is malignant or benign. I believe this is going to take place over the next couple of weeks.

I tell you this as my history but that I have no specialist medical knowledge and can only advise on the information that I have picked up along the way.

I don't think you should worry unduly although 3 months seems a long time to wait for a repeat FNA. However there may well be a good medical reason for this and they might want to see if the nodule has grown in that time. My understanding is that even if in the VERY RARE circumstance that it was malignant, thyroid cancer is very slow growing so 3 months would not be critical.

Does your nodule give you any symptoms? Hoarse voice, trouble breathing or swallowing? If not then maybe think about what you would want to do if they did offer you surgery. As being 4cms big that is the threshold where surgery is advised. However there are possible complications to thyroid surgery and you may decide that you would prefer a watch and wait approach if the nodule is benign and not causing you problems.

Gosh just realised this is a really long post so I hope it has been of some reassurance. I have been given some really good advice on this site and as you say it is so much better to be able to contact someone in the same position. Please contact me again if you have any more questions. Good luck and don't worry

[sakura20 in reply to Churchie]

Hi Churchie! Thank you so much for your reply. This means a lot to me. I feel much better now having received good advice to my post. It feels comforting to have someone to communicate with who is also in the same situation, who understands what I'm going through. Im so glad I found this community.

I don't have any symptoms at all. My nodule is not causing me any problem that's why I didn't know that it's there. Good thing I went to this doctor who was the one who noticed the lump in my neck. If not for her, I wouldn't know that I have a nodule.

Yes maybe there's a medical reason why there's a need to wait for 3 months before doing a repeat FNA. I am actually pushing for 2 months if possible. I had my FNA last Sep 4 but I'm requesting to have the repeat FNA next month.

Good luck to you too. I hope everything goes well with your repeat biopsy.

[Clutter]

Sakura, It's difficult to hit the right spot in the nodule which is why you need a follow up FNA. It's not unusual to have 3 indeterminate FNAs before deciding on surgery and histopathology on the larger sample will conclusively rule out or confirm cancer.

If a hemilobectomy (partial lobectomy) is done to remove the thyroid lobe and nodule, the remaining thyroid lobe will usually produce sufficient thyroid hormone but sometimes thyroid hormone replacement, Levothyroxine, is required too.

I had an inconclusive FNA too, but they didn't repeat it because the nodule was compressing my windpipe and made breathing and swallowing difficult so hemilobectomy to remove it was scheduled. Unfortunately histopathology was Hurthle cell carcinoma so completion thyroidectomy was done 3 months later but cancer is still very rare.

[sakura20 in reply to Clutter]

Hi Clutter! Thank you so much for your reply. If my repeat FNA will still show inconclusive result, then I think I will have to opt for partial lobectomy. But I'm also scared as I've read that some had a hard time dealing with the post surgery period. I am hoping that it will come out benign so I don't need to have an operation. But having this big 4 cm nodule, I think I don't have a choice but to have it removed eventually, though it's not causing me any problem now.

I hope all is well with you now and thanks again for your advice. Very much appreciated.

Sakura

[Sherry54]

I had a full body scan in 2010 and 3 thyroid nodules were seen. I then had an ultrasound, and got the same results you got, but they wanted to do a fine needle biopsy to make sure it wasn't cancer. But the largest nodule was too small to get much tissue and I was told it was inconclusive. So every year I've had an ultrasound and no change. This year my 1.4 cm nodule grew to 2.0 cm. Along the way this year I've had a hoarse voice, swallowing and breathing difficulties, this time the doctor sent me to the surgeon. The surgeon doesn't feel a 2.0 cm nodule can cause all these issues. His opinion. He said unless it's cancer he wouldn't remove it until it grew to 5.0 cm. But I said wait until it's 5.0 cm then I'll be older, the surgery more risky and you'll have to remove my entire thyroid instead of a part of it! But he's sending me for another fine needle biopsy to see if it's cancer or not.

I think someone needs to explain to you the results that have been found. The FNA should show clear results at 4.0 cm. And ask the hazards of leaving it there to grow, I think mines pressing on my windpipe and causing the issues I'm having.

Sounds like you have a great doctor whose paying attention. But you need someone to explain those results and what now?

Sherry

[sakura20 in reply to Sherry54]

Thank you Sherry for your reply.

My doctor is not an endo that's why she was surprised when I came back to her to get the result of my FNA. She was expecting the endo who supervised the FNA test to explain the result to me. But I told her that the endo asked me to see my doctor as the hospital will forward the result to her since she was the one who requested the FNA. I also called the hospital and they said the same thing, they will forward the result to my doctor. Maybe that's the hospital's protocol. That's why my doctor was mad because she said she is not a thyroid specialist so she can't explain to me the results clearly. I told her I just want to see the result because I'm so worried. She called the endo and scheduled me to see the endo in a couple of weeks so I can get clarity on the results.

Clutter mentioned that it's difficult to hit the right spot in the nodule. Maybe it is harder if the nodule is big.

FNA comments:

In the presence of micro follicular structures, obscuring blood and paucity of colloid, a definitive cytological diagnosis is difficult on this sample.

[Sherry54 in reply to sakura20]

Wow, sounds like the nightmare I'm going through for about a year now. I blamed a lot on menopause, but now know, there's more going on since it's all gotten worse. I ask my doctors office to fax me all my blood work results and diagnosis every time i have anything done, so even though I don't know how to interpret them I have them. Smart you got it. I keep a notebook and spreadsheet. My doctors office told me my results were inconclusive, but I also met with the surgeons office who told me the same thing. I didn't ever meet with the doctor that did the procedure, I'm not sure who he was!

I'm glad you have an appt with the endo but 2 weeks jeez! My nodule is 2.0 cm and the surgeon told me this time it's big enough they shouldn't have any problem getting tissue and knowing for sure if it's cancer or not. So I cannot imagine yours at 4.0 cm they couldn't get enough tissue to be "definitive". But this is the result I got the first time too.

I've had tumors removed from my right foot, my right breast and a hysterectomy, all because of cysts and tumors, so I don't worry I have canceer. And it doesn't run in my family. But I still want to know 100% it's not cancer, and I want to know it's not a nodule that's producing thyroid hormones and causing some of my problems. Some do and some don't.

Do let us know what you learn from the endo, and sounds like you have a doctor with common sense who sees the ridiculousness of what's occurred. I sure wish I did!

Sherry54

[sakura20 in reply to Sherry54]

Oh wow! You've been through a lot. Hope everthing goes well with your repeat biopsy.

I requested my doctor to show me the results even if I don't understand the medical terms. I took a picture of it so now I have it in my phone :).

Our family has history of cancer. My mother died of ovarian cancer 20 yrs ago. Hers was already stage 4 and had spread to her uterus when it was detected. Last year my brother had an operation, they removed half of his liver to remove a 5cm tumor. Thank God it was benign so he's doing okay now. That's why I was so worried when I found out that I have nodule. I was so nervous and scared when the FNA was done? The waiting period to get the FNA result was so stressful, only to find out that it's inconclusive. So have to wait again :(.

[Sherry54 in reply to sakura20]

Not compared to many others, all those things went smooth and I moved on from them. All my tumors were benign. I assume this thyroid nodule is too. I'm so very sorry to hear about your Mother, I am very fortunate and grateful in my 50's to still have my parents. Who are healthier and more active than me!

I don't want to hear "inconclusive" again after going through th FNA, which I hated the first time! Which has me asking, me and friends who have been through the FNA, the injected me with a numbing shot, and then had me open wide and hold my breathe, as they stabed and restabed me! But this time they asked me to bring someone who can drive so they can knock me out, possibly. Did they knock you out?

Yes, the FNA is stressful but with the family history you have, I can imagine your worries are much higher than mine! I'm only worried it'll be inconclusive and like you, I'll have to have more of these darned things! And they aren't free here in California on my insurance! So you want it to be conclusive when you pay so nuch for it.

Take care and I look forward to hearing what you find out with the endo. Like I said they guranteed me they would know cancer or not with a 2.0 cm so why wasn't yours conclusive I wonder.

Sherry54

[sakura20 in reply to Sherry54]

Thank you Sherry. Sure I will post my updates here. I'm so glad I found this community. I'm 49 now and I think the risk gets higher as we age.

I went to the hospital alone when I had my FNA. I was so nervous and my blood pressure even went up, but the doctor and the nurses assured me that the procedure is not that painful. No, they didn't knock me out. There was no injection , the doctor applied I think a numbing gel or something prior to the pricks. It was uncomfortable but not as painful as I imagined. I was poked 4 times, the prick felt like mosquito bite. Then the doctor advised me to take a rest so I slept the whole afternoon after the test :).

Good luck to the both of us. Hope we'll get conclusive results this time. Take care.

[Sherry54 in reply to sakura20]

They did give me a numbing shot but the hold your breath and don't swallow was the hardest part! I'll drag my husband with me anyway. They did mine at the lab that does x-rays and other tests. I'm positive my blood pressure will be high and my heart racing until it's over with! Even though I've done it before I can't dial down the anxiety I feel over it. It's part of my menopause issues, I think, I don't know anymore!

Yes, good luck to us both getting something more conclusive!

Sherry54

[sakura20 in reply to Sherry54]

Thank you Sherry. Hope all goes well with you.

I have the same problem, my blood pressure goes up and I can feel my heart pounding every time I go to the hospital. How much more if I need to undergo surgery to remove the nodule :(.

[kristan65]

Hello,

At least your doctor id doing test.

I went to my doctor and asked him to do a test and was told that in order for him to test he has to operate. How silly of me never had any problem with my throat only headaches had the surgery and the synthroid med is given me problems. Please don't let them operate you will never be the same again. Right now I have thrust, candida, just sick all the time since operation and seen where a lot of people are sick from taking their thyroid out.

[sakura20 in reply to kristan65]

Thanks Kristan. I'm afraid of surgery and the risk associated with it. I hope I will not need it.

[Sherry54]

I've had surgeries and none bothered me, and then the last few I I was a basket case, I shook and shook and was soooo cold I couldn't stop shivering I was so petrified. And lets not mention my bowels. So I understand. But I tell myself over and over and over...you'll feel better you'll wake up and carry on with your life.

Sherry 54