Thyroid FNA - results suspect cancer - but could result be compromised ?

Hi !

This is my first post here. I'm Male, 57 and have suspected thyroid cancer. My only symptom is being able to feel a small lump on the right hand side of my neck lower down. Its not visible, soft & difficult to feel unless I stretch my neck back. This was about 5 months ago. The lumps not got any bigger, if anything smaller since then. Thyroid levels are normal.

I was sent to an ultrasound and the result came back as needing further investigation. Lump is mixed, about 2 / 2.7cm, mix of solid/liquid, 70% solid. So I was sent for an ultrasound guided FNA by the specialist.

The ultrasound doc took 2 samples. Doc said afterwords that he would be "very surprised" if the lump turned out to be malignant. Had a full neck scan and there does not seem to be any lymph node involvement.

2 weeks later the results came back. They could not make a diagnosis as the samples were contaminated with blood. Was sent there and then for another FNA. This time the doc performing the ultrasound (seemed more experienced) said "I'm not going to perform the FNA as your lump is very clearly benign, not just on the margin, but very clearly !" I was relieved by this but told him I was sent down to have a second FNA by the specialist due to blood contamination on the first sample. He said this was common and that the blood contaminate caused the cells to look different - hence not useful for diagnosis. This time he took 3 samples, much more vigorous in probing the lump. I think at least 1 looked to be contaminated again.

Came back 2 weeks later, expecting results to be benign, instead the consultant said results showed suspected cancer ! I was stunned & shocked. I asked how certain he was, said that the probability is 75% that its cancer !

I need to have the lump removed and was offered either partial or full thyroid removal. I'm also going to have a CT scan.

I'm going to opt for partial removal as it appears I have a 1 in 4 chance that the lump is actually benign. I hope (and pray) that this is the case. All the other results seem to suggests its actually benign. Specialist says it will be slow growing. I'm scheduled to have the op in about a month and a half from now. If it is cancer then the remaining node needs to be removed - due to an intervening holiday about 2 months later.

My question is this - Could the results be compromised by the first FNA taken 2 weeks prior, giving a false positive result in the second test ? I'm thinking that if bleeding causes the cells to look different then possibly the first test would have bled in to the lump, explaining the suspicious result. I'm hoping that this might be a plausible explanation.

Is this possible ? Does anyone have experience of FNA's being so wrong ? . I have a long time to worry !

1 Reply

  • Robo87,

    While I've read several posts where members have had inconclusive FNA's which have been found to be malignant in histopathology when the larger tumour sample is analysed I've not read posts of positive FNA's being found benign later. Have they been able to determine whether it is likely to be papillary or another type of cancer from the FNA?

    I had thy3 (inconclusive) FNA but it wasn't repeated as hemilobectomy was scheduled to remove the nodule which was compressing my trachea. Tumour turned out to be malignant and as it was a fairly aggressive type (Hurthle cell) it was recommended I had completion thyroidectomy 3 months later followed by radioactive iodine ablatement (RAI) to destroy any remnant cells left in the thyroid bed and loosened by surgery. The cancer hadn't spread to the remaining lobe.

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