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johns hopkins FNA report

Dear Dr. Lupo,

as per your suggestion I sent my FNA slides to Johns Hopkins for a second opinion. My local hospital recommends that I remove the thyroid based on some observations of nuclear grooves and inclusions.

However the John Hopkins report recommends that I repeat FNA in 3 month.

Here is the Johns Hopkins report:

Final Diagnosis: Atypical Cells of Undetermined Significance (see note)

Adequacy: Adequate

Note: Focal intranuclear pseudoinclusions are present.

Recommend (if clinically indicated): Repeat FNA in 3 month.

Which one is more likely accurate? The second report does not mention the presence of nuclear grooves.
My endo insists that I should remove the thyroid ASAP.  Do you think it is better to follow the Johns Hopkins advice or the take my thyroid out? I do not have any symptoms and normal thyroid hormones.

Thank you
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97953 tn?1440865392
MEDICAL PROFESSIONAL
The director of cytopathology at Hopkins is Doug Clark (see if he read your case)...he was instrumental in helping develop the new classifcations for thyroid FNA and the "atypical of uncertain significance" is a new category that many docs are not yet familiar with.  This caries a 5-10% risk of malignancy and the recommendation is repeat FNA in 3 months.  If it remains atypical (or worse), then surgery.  Would have next FNA also sent to Hopkins for eval in this case.
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Avatar universal
Today I met another endo for a second opinion and she told me that repeat FNA is not likely to change anything as they have already found atypical cells. I have to do FNA until they hit cancer.
She also mentioned that according to my FNA reports I have 20% chance of cancer. She suggested L lobectomy would be a better option than TT. My first endo told me that TT is better.

Is lobectomy has significantly less risk that TT ( I am asking this because I am not sure my surgeon has a lot of experience in thyroid surgery, my insurance does not allow me to choose any surgeon I want)

Thanks
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