Indeterminate FNA repeating biopsy within 2 weeks if result the same surgery

[lostmyoldlogin]

Hi can't find my posts from a month or so ago but the consultant called today biopsy was on Monday indeterminate have to repeat within two weeks if same result then surgeon for partial thyroidectomy - I know they got a good sample they told me they did so...

[Clutter]

Lostmyoldlogin,

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Indeterminate isn't due to lack of sample it's because the analysis isn't clearly benign or malignant. If the 2nd FNA is indeterminate and you agree to hemilobectomy the tumour will be analysed and the larger sample will give a conclusive result.

[lostmyoldlogin in reply to Clutter]

Thanks this is what I've asked for she said we have to follow protocol and repeat first xx could it then come back benign a second time? Or would it only be useful to confirm malignancy ahead of surgery e.g.: if I end up with indeterminate and a all clear will they just leave me? Xx

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

It could come back benign, malign or indeterminate again. It's a bit hit and miss taking a sample from the right area of the nodule. If you get a benign result and the nodule isn't causing bother you won't need surgery.

Some people have 3 indeterminate FNAs before having hemilobectomy. I only had one because the nodule was compressing my trachea so needed to come out. Unfortunately in histopathology the tumour was malignant so I had competion thyroidectomy 3 months later.

[lostmyoldlogin in reply to Clutter]

It was found because I self referred I know there's something serious up just not sure where it started and how far it's got to be honest I have an enlarged lymph node in my groin same side as the back hip and knee pain if it comes back benign I will beg them to do a partial because my nan her sister and my auntie had thyroid cancer a long time ago before they could define types etc so I don't know if a specific gene or not but I have a hunch and the ibs they diagnosed me with has gotten worse and worse they have never scanned or put a camera in and my dads dad died of stomach cancer my sister is awaiting a total mastectomy due to early onset breast cancer brca 1 gene they have t tested me as we have different dads if it's follicular it would explain my brain cyst causing symptoms when it shouldn't be my heads a mess but I feel Like at last I'm getting answers - gp has fobbed me off with anxiety since my baby was stillborn and a midwife suspected my thyroid - a year ago ambulatory care took me in via my gp for tachycardia and low body temp I'm still having severe night sweats after a total hysto didn't cure them and hrt making no difference I'm ok but if I tried to get on my kayak and go round the point like I used to I would be dizzy breathless and in serious trouble within 10 mins so I'm grounded have been 4 yrs now I know my limits u have to on the sea I think without that I would just think I felt a bit fluey I guess - either way I need them to find it whatever and wherever it is xx

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

A malignant thyroid nodule is usually asymptomatic and is unlikely to affect thyroid levels.

I had euthyroid Hashimoto's which made me feel hyper most of the time but eventually I swung between feeling hyper and hypo. I got no help because GP and surgeon said symptoms were non-thyroidal because thyroid levels were unequivocally normal. After thyroidectomy symptoms improved quickly, probably because there was no longer a thyroid for Hashimoto's to target.

[lostmyoldlogin in reply to Clutter]

They've tested my thyroid antibodies all negative only thing up is tsh 0.1 t3 and t4 high but in range so they just tell me I'm anxious so I don't go back for months as I don't want them to think that of me and ended up every trip I made them think it more

Tsh 0.7 2014 tsh 0.5 2015 tsh 0.3 2016 now 0.1 xx

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

If you're not taking thyroid replacement TSH 0.1 indicates hyperthyroidism. Have they not tested FT4 and FT3 now that TSH has dropped to 0.1?

[lostmyoldlogin in reply to Clutter]

Yes will quickly look it up and tell u xx

[lostmyoldlogin in reply to Clutter]

Free t4 is 12 range 9-19

Cortisol is 260 9am addisons ruled out as raised to 529 on synacthen

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

FT4 is normal but I think your GP or endo should be testing FT3 to see whether that is high and suppressing your TSH.

[lostmyoldlogin in reply to Clutter]

4.88 on private result sept 2016 (t3)

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

Was Sept 2016 when your TSH dropped to 0.1?

[lostmyoldlogin in reply to Clutter]

0.17

[lostmyoldlogin in reply to Clutter]

My dr said it was all fine I'm imagining my bmi being 18 and my heart rate going mental! Lol x

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

It's not fine. TSH dropping to 0.1 when not taking thyroid replacement indicates hyperthyroidism and as FT4 is normal FT3 should be monitored too to rule out overt hyperthyroidism. Show your GP the NICE recommendations for managing subclinical and over hyperthyroidism in cks.nice.org.uk/hyperthyroi...

How can you imagine BMI 18? Racing heart and pulse and palpitations are signs of hyperthyroidism.

[lostmyoldlogin in reply to Clutter]

Yes dizzy heart rate breathless dr didn't like my stats and sent me in

Inflammation markers and only anomaly thyroid retest in 2 weeks the gp did a month later when I insisted and it came back the same they said it's fine. I then paid for private bloods and queried all of it with gp and begged for Endoc appointment she said expect them to send me home as anxious - I'm still having tests 2 months later from first meeting the Endoc x

[lostmyoldlogin in reply to Clutter]

Endoc found the lump when she examined me after I explained my symptoms - larger than 1 cm solid nodule with 2 smaller ones near it x

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

Nodules <1 cm are usually to small to FNA biopsy but if the scan showed suspicious characteristics on the larger nodule they may be able to FNA biopsy it.

[lostmyoldlogin in reply to Clutter]

They have and it has come back after 4 days as indeterminate they had a good sample so if they repeat and get same result partial tt xx

[Clutter in reply to lostmyoldlogin]

Lostmyoldlogin,

Of course, I'd forgotten the earlier conversation. Has your endo done a RAI uptake scan to check thyroid function?

[lostmyoldlogin in reply to Clutter]

Not yet waiting for next biopsy xx

[lostmyoldlogin in reply to Clutter]

Weird thing is I sat on my phone all Friday morning and knew the call was coming was very strange xx

[lostmyoldlogin in reply to lostmyoldlogin]

They rescanned the nodule I still feel I’ll they basically said they will re scan again in 2 months now my tsh still o.1 Neuro has put me on topamax for pineal cyst migraine said it’s incidental still got hyper symptoms now waiting on ibs ibd calprotectin to come back as still not well