I had a total thyroidectomy on 7/25 and the path results are:
"Histologic type: Papillary Carcinoma
Tumor laterality: left central lobe
Tumor size: 1.0 cm
Lymph-vascular invasion: not identified
Extrathyroidal extension: not identified
Stage: T1a, N0, MX
Lymph node, Left Paratraceal/pretracheal Lymph Node Resection: Five of Five negative for malignancy
TP, FS3, A through V: Sections show portions of thyroid parenchyma. Within there is an identified lesion showing both papillary structures and follicular structures lined by a columnar to cuboidal epithelium. The cell nuclei show areas of nuclear clearing. There are associated psammoma bodies in areas. Surrounding the lesion there is a fairly fibrous capsular material. The tumor extends into the capsule in areas and into thyroid parenchyma. While the capsular tissue involves the blue-inked margin of excision, actual tumor cells do not.
W though Y: Sections show a nodular portion of benign thyroid parenchyma. Although, none of the lymph node shows metastatic malignancy, one of them shows isolated psammoma bodies. Multiple levels through this lymph node shows no metastatic papillary carcinoma. There are 5 lymph nodes in total."
1. Based on "Within there is an identified lesion showing both papillary structures and follicular structures lined by a columnar to cuboidal epithelium," can it be concluded that my thyroid cancer is of the columnar variant? I am worried about this because I have read that columnar variants are more aggressive and have worse outcomes.
2. My endo referred to the quoted part in 1 and that the tumor was not encapsulated, to conclude that my cancer is a bit more aggressive. She also said that I may not need RAI or if I did it will be 29 millicuries. Because my cancer is more aggressive, would it be OK to skip RAI?
3. Is the cancer well-differentiated? Could you comment on my prognosis?