Aa
Pathology report
Went to pre-op today, this is my pathology report. I really don't understand the oncocytic word (will have to look it up)--from what I was told, it is good news. As 'far as they can tell' it is confined to the thyroid. I will have tt on 11/18, start Synthroid 125 mcg. in hospital, will deal with radiation after thyroid heals.
Okay, I am ready for you to grade me in understanding!!! Did I aget an A?
COMMENT:
Thank you for sharing this most challenging case with us. In our opinion the larger nodule represents an oncocytic follicular variant of papillary carcinoma. The follicles present within this lesion are large in caliber and are lined by cells that are though oncocytic, show nuclear features, namely enlargement clearing elongation, overlap, and membrane irregularities (particularly on slide A4), that are compatible with the below diagnosis.
Additionally we found at least three incidental foci of papillary thyroid microcarcinoma present on A3 and A5 (your original slides), and A4 (our recut)
FINAL DIAGNOSIS:
Part 1: Thyroid, right lobe, lobectomy (8.3 grams) (OSS S08-7463, 10/21/2008)
A. Papillary thyroid Carcinoma, oncocytic variant (1.5cm)
B. Three additional foci of papillary thyroid microcrcinoma (Range : less than 0.1 cm to 0.1cm)
C: No angiolymphatic invasion present, all foci confined to thyroid.
D: Intrathyroidal thymus.
Part 2: Parathyroid, right excision (8.3 grams)
A. Normocellular parathyroid
B. Thymus with no significant Abnormalaties.
Okay, I am ready for you to grade me in understanding!!! Did I aget an A?
COMMENT:
Thank you for sharing this most challenging case with us. In our opinion the larger nodule represents an oncocytic follicular variant of papillary carcinoma. The follicles present within this lesion are large in caliber and are lined by cells that are though oncocytic, show nuclear features, namely enlargement clearing elongation, overlap, and membrane irregularities (particularly on slide A4), that are compatible with the below diagnosis.
Additionally we found at least three incidental foci of papillary thyroid microcarcinoma present on A3 and A5 (your original slides), and A4 (our recut)
FINAL DIAGNOSIS:
Part 1: Thyroid, right lobe, lobectomy (8.3 grams) (OSS S08-7463, 10/21/2008)
A. Papillary thyroid Carcinoma, oncocytic variant (1.5cm)
B. Three additional foci of papillary thyroid microcrcinoma (Range : less than 0.1 cm to 0.1cm)
C: No angiolymphatic invasion present, all foci confined to thyroid.
D: Intrathyroidal thymus.
Part 2: Parathyroid, right excision (8.3 grams)
A. Normocellular parathyroid
B. Thymus with no significant Abnormalaties.
okay, I will shut up and quit bugging you.
Enjoy your bath and relax....hope you feel better.
night
Enjoy your bath and relax....hope you feel better.
night
Hey, you guys here are my sanity!! Besides, I figure if you've had to go through this stuff alone you learn that you don't ever want anyone else to so, yeah, I stick around to harass all of you guys! :-)
Okay, to your question . . . you just want to task my one, last neuron that I have still firing, don't you? :-)
Here's what I found. Oncocytic carcinomas can be either simply oncocytic, Hurthle cell, oxyphilic cell, or askanazi cell carcinoma.
If you ask me what these mean I'm going to punch you. (kidding)
Here's what they look like on pathology: Grossly, oncocytic adenomas are encapsulated, solid nodules with a characteristic brown cut surface. Secondary changes, including infarction and hemorrhage are common (particularly after fine needle aspiration), possibly as a result of the low tolerance to ischemia displayed by the oncocytes. Histologically, the follicular growth pattern is most common but cells may also be arranged in trabeculae, solid sheets or papillary formations.
One diagnosis tool for oncocytic varient is: Chromosomal DNA unbalance and aneuploidy are present in 70-80% of oncocytic thyroid neoplasms.
(meaning that they have very different DNA than surounding tissues)
Okay - my brain hurts now. :-) I have to take some meds and a hot bath - I think I've coughed up a lung.
I'm going to send you a message with the link to this article (I can't paste it here MedHelp will delete it then smack me upside the head)
Utah
Okay, to your question . . . you just want to task my one, last neuron that I have still firing, don't you? :-)
Here's what I found. Oncocytic carcinomas can be either simply oncocytic, Hurthle cell, oxyphilic cell, or askanazi cell carcinoma.
If you ask me what these mean I'm going to punch you. (kidding)
Here's what they look like on pathology: Grossly, oncocytic adenomas are encapsulated, solid nodules with a characteristic brown cut surface. Secondary changes, including infarction and hemorrhage are common (particularly after fine needle aspiration), possibly as a result of the low tolerance to ischemia displayed by the oncocytes. Histologically, the follicular growth pattern is most common but cells may also be arranged in trabeculae, solid sheets or papillary formations.
One diagnosis tool for oncocytic varient is: Chromosomal DNA unbalance and aneuploidy are present in 70-80% of oncocytic thyroid neoplasms.
(meaning that they have very different DNA than surounding tissues)
Okay - my brain hurts now. :-) I have to take some meds and a hot bath - I think I've coughed up a lung.
I'm going to send you a message with the link to this article (I can't paste it here MedHelp will delete it then smack me upside the head)
Utah
Well I appreciate all you do ...I learn a lot from ya.
It amazes me that with all you are going thru that you take the time to help others...AWESOME woman!
ok, trying to become google savvy like you, so I have 1 more question before bed...does oncocytic variant mean Hurthle cell?
It amazes me that with all you are going thru that you take the time to help others...AWESOME woman!
ok, trying to become google savvy like you, so I have 1 more question before bed...does oncocytic variant mean Hurthle cell?
That just means that oncocytes tumors could be made in other organs. Don't worry - yours was made in your thyroid and comprises papillary thyroid carcinoma.
Many cancers are like this. My GI actually told me that papillary carcinoma can start in the bile ducts - it's not thyroid cancer (when it starts there) at all but just the structure of the cancer cell is called papillary carcinoma. Papillary carcinoma can also be a (rare) type of breast cancer.
What weird things our bodies can do to undermine us, eh?
Nah, brain fog and fear of math would keep me from med school - not to mention my age and my inability to deal with stupid people which god complexes :-) I have just learned to become the queen of googling medical articles. Something this stupid thyroid cancer taught me. :-)
Many cancers are like this. My GI actually told me that papillary carcinoma can start in the bile ducts - it's not thyroid cancer (when it starts there) at all but just the structure of the cancer cell is called papillary carcinoma. Papillary carcinoma can also be a (rare) type of breast cancer.
What weird things our bodies can do to undermine us, eh?
Nah, brain fog and fear of math would keep me from med school - not to mention my age and my inability to deal with stupid people which god complexes :-) I have just learned to become the queen of googling medical articles. Something this stupid thyroid cancer taught me. :-)
Wow, you are good at getting info....you are awesome.
I never understand the first part and then you explain it to me...you otta be a doctor!
HEY__I DON"T LIKE THIS LINE__PLEASE INTERPRET:
"Tumors composed of oncocytes are not restricted to the thyroid gland and may arise in a variety of locations, most commonly in the kidney and salivary gland and may be benign or malignant"
I never understand the first part and then you explain it to me...you otta be a doctor!
HEY__I DON"T LIKE THIS LINE__PLEASE INTERPRET:
"Tumors composed of oncocytes are not restricted to the thyroid gland and may arise in a variety of locations, most commonly in the kidney and salivary gland and may be benign or malignant"
Wow girl - you're over achieving! :-)
Onocytes is a variant of the papillary (or follicular) cancer so you are right - it is good news. It's *NOT* medullary or anaplastic - *very, very good news*!
Here's what I found on onocytes (from atlasgeneticsoncology.org)
*************************************************************
Oncocytes (from the greek word "swell"), also known as Hurthle cells, oxyphilic cells or Askanazy cells, are characterized by abundant granular cytoplasm due to aberrant accumulation of mitochondria. The cause for the mitochondria accumulation is unknown. The increased number of mithochondria may be a compensatory to intrinsic defects in the energy production machinery of the cell. Cells that fit this basic description may be identified in a variety of non-neoplastic lesions as well as in the affected tissues of patients with mitochondrial myopaties.
Tumors composed of oncocytes are not restricted to the thyroid gland and may arise in a variety of locations, most commonly in the kidney and salivary gland and may be benign or malignant. By convention, thyroid tumors are designated as oncocytic if at least 75% of their constituent cells can be described as oncocytes. In the context of the traditional classification of differentiated thyroid tumors of follicular cell derivation into follicular and papillary histotypes, the majority of oncocytic neoplasms represent a distinct subtype of thyroid follicular tumors. Papillary carcinomas, as well as a few medullary thyroid carcinomas, may also be oncocytic but for the purpose of this brief review, "oncocytic tumors" will refer to the follicular cell derived neoplasm that lacks nuclear features of papillary carcinoma.
Thyroid oncocytic tumors are neoplasms composed by a majority of cells with the morphologic features of oncocytes.
*************************************************************************
You have that way cool, rare type of papillary carcinoma in the large nodule and three microcarcinomas (very, very common with papillary carcinoma and one major reason the entire thyroid has to be removed). It looks like it is confirmed to the thyroid, which is cool, and that it isn't in the parathyroids. Wahoo.
One thing though is that this site states: "Oncocytic carcinomas tend to have lower iodide uptake compared with non-oncocytic cancers and are often therefore less responsive to radioactive iodide administration." (Meaning that the RAI will kill off the healthy thyroid tissue, the papillary carcinoma, and probably most of the oncocytic carcinoma but another method may need to be used if it isn't all removed by surgery)
It also states that oncocytic carcinomas don't tend to spread so, wahoo! If it was all in that area removed during the surgery then problem solved! (but you will still need RAI because of the papillary carcinoma)
Won't you be glad to get the rest of that mess out and get on with RAI and healing?!?!
Stay strong! HUGS
Utah
Onocytes is a variant of the papillary (or follicular) cancer so you are right - it is good news. It's *NOT* medullary or anaplastic - *very, very good news*!
Here's what I found on onocytes (from atlasgeneticsoncology.org)
*************************************************************
Oncocytes (from the greek word "swell"), also known as Hurthle cells, oxyphilic cells or Askanazy cells, are characterized by abundant granular cytoplasm due to aberrant accumulation of mitochondria. The cause for the mitochondria accumulation is unknown. The increased number of mithochondria may be a compensatory to intrinsic defects in the energy production machinery of the cell. Cells that fit this basic description may be identified in a variety of non-neoplastic lesions as well as in the affected tissues of patients with mitochondrial myopaties.
Tumors composed of oncocytes are not restricted to the thyroid gland and may arise in a variety of locations, most commonly in the kidney and salivary gland and may be benign or malignant. By convention, thyroid tumors are designated as oncocytic if at least 75% of their constituent cells can be described as oncocytes. In the context of the traditional classification of differentiated thyroid tumors of follicular cell derivation into follicular and papillary histotypes, the majority of oncocytic neoplasms represent a distinct subtype of thyroid follicular tumors. Papillary carcinomas, as well as a few medullary thyroid carcinomas, may also be oncocytic but for the purpose of this brief review, "oncocytic tumors" will refer to the follicular cell derived neoplasm that lacks nuclear features of papillary carcinoma.
Thyroid oncocytic tumors are neoplasms composed by a majority of cells with the morphologic features of oncocytes.
*************************************************************************
You have that way cool, rare type of papillary carcinoma in the large nodule and three microcarcinomas (very, very common with papillary carcinoma and one major reason the entire thyroid has to be removed). It looks like it is confirmed to the thyroid, which is cool, and that it isn't in the parathyroids. Wahoo.
One thing though is that this site states: "Oncocytic carcinomas tend to have lower iodide uptake compared with non-oncocytic cancers and are often therefore less responsive to radioactive iodide administration." (Meaning that the RAI will kill off the healthy thyroid tissue, the papillary carcinoma, and probably most of the oncocytic carcinoma but another method may need to be used if it isn't all removed by surgery)
It also states that oncocytic carcinomas don't tend to spread so, wahoo! If it was all in that area removed during the surgery then problem solved! (but you will still need RAI because of the papillary carcinoma)
Won't you be glad to get the rest of that mess out and get on with RAI and healing?!?!
Stay strong! HUGS
Utah
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