Results of Ultrasound guided FNA

[Migz88]

Hello,

I got the final cytologic diagnosis results of my Ultrasound guided FNA of a thyroid nodule. My question is, given the results, should I relax a bit about the chances of having Thyca, or should I push for a second opinion? The ENT who ordered the biopsy wants to have a "wait and follow up" approach, seeing me again in 6 months for exam of the thyroid, and if any growth ultrasound/biopsy again. Should I relax, given this findings and try not to worry about it?


Any help is appreciated, and here are the results:

Bethesda Class: Benign Thyroid/Follicular Nodule

Features are consistent with:
Nodular goiter, predominantly cystic degeneration with colloid hemosiderin containing histiocytes seen--suggests recent hemorrhage.

Comment: The FNA biopsy shows a colloid rich specimen with abundant hemosiderin laden macrophages and benign appearing follicular epithelial cells. There are no architectural or cytologic features suggesting neoplasm.

Comment/Micro Findings:
Technical findings of thyroid ultrasound examination:

An ultrasound scan was performed of the thyroid gland in the transverse plane from superior to inferior and in the saggital plane from lateral to medial. The isthmus was evaluated in the transverse plane. The right lobe measures 5.31 x 1.40 x 2.14 CM. The left lobe measures 5.42 x 1.36 x 1.74 CM. The isthmus is 0.44CM in thickness. Thyroid gland echotexture is heterogeneous with multiple very small nodules, bilaterally. Thyroid gland vascularity is within normal limits.

The right lobe shows the following dominant nodule: 1.28 x 0.79 x 1.21CM, right mid lobe, cystic with solid component, hypoechoic nodule, peripheral vascularity with minimally increased internal vascularity, no calcifications. No discrete nodules are identified in the isthmus. Tiny nodules are identified in the right and left lobes.


Thank you for your help, everyone, as this is causing me considerable anxiety.

[Migz88]

That is also what doctor said, we will examine again in 6 month, if significant growth, ultrasound and biopsy again.  

Thanks for everything!

[898_1]

I would consider re-test in 6 months. but so far nothing shows any hints of tumor

[Migz88]

No, not that I am aware of.  I'm not sure why there was a hemorrhage.  So if this were you, would you relax a bit?  Or would you still be concerned of malignancy?

[898_1]

The content of the nodule includes white blood cells and the components of dried blood mixed with random follicular cells this is why the pathologist believes the nodule is benign. If such follicular cells are arranged in sheets this will point to tumor.
Not sure what caused hemorrhage in the first place; any past neck injuries?