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inconclusive fna...thyroidectomy drastic move??
Hi, My name is Cath and I'm 52. I have 5 nodules, two of which are 20mm and 16 mm in size on both sides of the thyroid. Six months ago they were half that size. They elected to watch and wait. I have had a terribly sore throat and gravelly voice that comes and goes but the "soreness" is unbelievable. I had a FNA that was done Dec.6th that was "inconclusive" although I was stabbed 7 times. The Endocrinologist who is away actually called me and gave me three options to consider. #1..get the thyroid out #2 go back and have another fna and hope that something is seen.#3 Do nothing, watch and wait...monitor the nodule sizes.
Now, I am not thrilled about removing a non-cancerous gland nor am I particularly thrilled about goig under the knife. I am 100% pacemaker dependant with a bum heart, The idea of waiting another six months and potentially letting a cancer spead is not a great option for me. i already have periods where my glands are inflamed in my neck...In two weeks we discuss it again with my decision.. I am leaning toward going to getstabbed again but having someone else have a go at the FNA to increase my odds of a good sample...oh, btw. on top of the thyroid stuff I also have lupus (SLE) and this 3rd degree AV block which requires the pacemaker...........comments as to what to make of this inconclusive result or non result etc. welcome..................thanks, Cath
Now, I am not thrilled about removing a non-cancerous gland nor am I particularly thrilled about goig under the knife. I am 100% pacemaker dependant with a bum heart, The idea of waiting another six months and potentially letting a cancer spead is not a great option for me. i already have periods where my glands are inflamed in my neck...In two weeks we discuss it again with my decision.. I am leaning toward going to getstabbed again but having someone else have a go at the FNA to increase my odds of a good sample...oh, btw. on top of the thyroid stuff I also have lupus (SLE) and this 3rd degree AV block which requires the pacemaker...........comments as to what to make of this inconclusive result or non result etc. welcome..................thanks, Cath
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COMMUNITY LEADER
If you are only eating 1500 cal/day diet, that may be your problem, with weight. You need so many calories to maintain your bodily functions (heart beats, lung function, kidney function , etc) -- if you go below the number of calories required for basic bodily functions, you will not lose weight -- your body will hold onto fat, thinking that there won't be enough food coming in......
Why not start a separate post with your own thyroid labs, including reference ranges, on which members can comment?
Why not start a separate post with your own thyroid labs, including reference ranges, on which members can comment?
I know how you feel about wanting to forget about not feeling well. I'm so tired of complaining and wondering if I'm nuts! I haven't believed that my thryoid is working properly for quite some time...long before this nodule. But...everything is within range. Case closed. But it makes no sense that a 6ft tall woman, exercising 2 - 3 times per week and on a (roughly) 1500 cal/day intake should GAIN wait. Then there's the fatigue, difficulty sleeping (isn't exercise supposed to HELP all that?) etc. etc. etc. So - I'm diagnosed with PCOD because of multiple cysts on my ovaries and am put on the BCP (at 42! don't like that!) to control menstrual issues and then some. I really believe that this is all linked to my thyroid - despite being in "range" but got tired of pushing and fighting. Now at least I have this nodule that says 'something isn't right in here". If I were you I would fight. Don't let it go. Nobody will look out for you better than you will. Don't let it rest in someone elses hands...that's what I say. :-)
I think you likely made the best decision for you. I also know a lady's whose biopsy was benign but it was in fact malignant..I haven't heard anything back. Yes, The last one seemed to be benign but they are still there and had doubled in size over six months to 2cm and The raspy throat etc. continue. I expect I've heard the last of them unless I push the point. Not sure what to do yet.
Hi there...just read your thread. I have a similar issue. I have a solitary, solid, cold nodule that I've been watching for just over a year. My last follow up (just over a week ago) showed that it hadn't really grown BUT...it had morphed in dimension. First biopsy was benign. For the first time my Dr. gave me a number....20% chance of malignancy. I've been sitting with this awhile as he gave me the option of what to do. I've combed a lot of boards and asked for a number of opinions. One friend had his out...not cancer but it was large. He said "if i had even a ONE percent chance of cancer I would not risk it!". His mother had a benign biopsy but opted for surgery...hers was malignant and had spread to her joints. I know there are a ton of horror stories out there...and likely as many good ones but, for me...20% is enough of a risk that I'm not willing to take. Given that it's the LIST of bad characteristics (solitary, solid, cold, largish). For awhile I thought - well, at least I don't have a family history until my Mom reminded me that we don't KNOW my family's history! He was adopted...and died at 63 of cancer. So young!
So - my thoughts were; If I remove it, I know I'll be ok. If I remove and it's cancer...I know I'll be ok. If I DON'T remove...well, I just won't know for SURE if I'll be ok.
I made the call Friday and am waiting for my ENT to call back for a date. It was a real struggle coming to this decision. I stressed and had anxiety over the decision more than what the final outcome may be. That also told me something...I just couldn't keep going and wondering every 6 months.
That's just me...my thoughts. Good luck to you and your decision. Keep us posted!
So - my thoughts were; If I remove it, I know I'll be ok. If I remove and it's cancer...I know I'll be ok. If I DON'T remove...well, I just won't know for SURE if I'll be ok.
I made the call Friday and am waiting for my ENT to call back for a date. It was a real struggle coming to this decision. I stressed and had anxiety over the decision more than what the final outcome may be. That also told me something...I just couldn't keep going and wondering every 6 months.
That's just me...my thoughts. Good luck to you and your decision. Keep us posted!
It,s like pulling teeth to find out results. I may never hear from them again. i don't have the energy right now to chase them. No, I don't smoke..I have dealt with illness so long sometimes i just want to forget it all.. really. Right now I am doing nothing..
COMMUNITY LEADER
Wonderful that the FNA is benign............
Post FT 3, FT4 and TSH results as soon as you get them, we can go from there......
The nodules aren't likely to go away - I have them too, but they aren't a worry, as long as they don't 'grow up'.......
Raspy voice indicates hypo, unless you smoke; I've been down that road and it could mean something else entirely....
Post FT 3, FT4 and TSH results as soon as you get them, we can go from there......
The nodules aren't likely to go away - I have them too, but they aren't a worry, as long as they don't 'grow up'.......
Raspy voice indicates hypo, unless you smoke; I've been down that road and it could mean something else entirely....
benign...........that's what I'm told.... repeat free t4 and tsh yesterday...so, Don't know where we go from here..I still have the nodules 2 cm and 16 mm with raspy throat and glands hard at times?? We will see I guess if I get a call back or have to ask my primary for ENT referral??
Hi all My second FNA went just fine. This fellow cared and it was very manageable. Now I wait 6-7 days and see if I get results this time one way or the other..I'll let you know the outcome..Cathy
COMMUNITY LEADER
When you get that T3 and T4 done in Feb, make sure they are for FREE T3 and FREE T4, not total. AND, make sure you get a copy of the lab report for your records. I keep my lab reports and mark on them, what med I was taking at the time, and how I felt; that's what I use to figure out which levels I want as my "targets".
Good luck in Tues, with the FNA.
Good luck in Tues, with the FNA.
They used two local injections last time, certainly didn't affect me in my ability to drive or take a train.. the actual prodding in and out was not so fun but necessary. I hope this Tuesday is not too bad..Thanks for your input everyone.....I feel positive about it all but then that's my nature....:)
Some of them use an anesthetic to numb the area especially if they are going to do multiple FNA's and that is why you would be told to take someone along.
I know after my 2nd lot of FNA, and they didn't use any anesthetic (the gauge needle is the same as the biopsy and only numbs the outside, so as the doc said, what's the point!) I felt really cruddy and wouldn't have driven if paid to! It was very uncomfortable, due to the positioning of the nodules at the back of the thyroid, felt like I had been beaten up. I couldn't turn my head at all due to pain, so I am glad I took someone with me to drive home!
Good luck with yours!
I know after my 2nd lot of FNA, and they didn't use any anesthetic (the gauge needle is the same as the biopsy and only numbs the outside, so as the doc said, what's the point!) I felt really cruddy and wouldn't have driven if paid to! It was very uncomfortable, due to the positioning of the nodules at the back of the thyroid, felt like I had been beaten up. I couldn't turn my head at all due to pain, so I am glad I took someone with me to drive home!
Good luck with yours!
I had seven jabs with lots of dipsey doodling so we will see what the second one is like.. they asked me to bring someone to drive me home which took me by surprise. I think that's unnecessary and I don't have anyone to do so anyway. I managed just fine with attempt #1. My endo sends us off to be done in radiology to have the ultrasound assistance. I guess once I have this done and a T3 T4 and TSH in Feb. I will know more... We will take it from there and see what else comes up. I really don't know if he tested for TPOab and TGab..I will ask..thanks you gals...
I definitely agree with Barb - you need blood tests & numbers. Being hypothyroid is one thing, having Hashimotos is another. Lupus makes the likelihood of auto-immune antibodies attacking your thryoid (Hashimotos Thyroiditus) a reasonable possibility!
WHY doesn't the doctor test your TPOab and TGab? Those tests and ultrasound diagnosis (lumpy gland & other echoic characteristics) are the only way to get a yea or nay. I believe that my nodules haven't grown over the last several months because I take thyroid hormones (in my case Armour)
With a TSH of 7.4 no doubt you need hormone - the FreeT3 and FreeT4 tests will help to figure out your dosage.
I am no expert, but my two cents is you need thyroid hormones.
Even on meds my gland acts up, especially when I am stressed it feels like it swells and I sort of feel like I could gag - but, then it goes away.'
My last FNA results were benign with no growth is size.
My first FNA was done at the hospital (almost passed out by needle #5, nausea, white lights twinkling stars) The second was done by my new endo at his office - he was very good - over & done no problem.
WHY doesn't the doctor test your TPOab and TGab? Those tests and ultrasound diagnosis (lumpy gland & other echoic characteristics) are the only way to get a yea or nay. I believe that my nodules haven't grown over the last several months because I take thyroid hormones (in my case Armour)
With a TSH of 7.4 no doubt you need hormone - the FreeT3 and FreeT4 tests will help to figure out your dosage.
I am no expert, but my two cents is you need thyroid hormones.
Even on meds my gland acts up, especially when I am stressed it feels like it swells and I sort of feel like I could gag - but, then it goes away.'
My last FNA results were benign with no growth is size.
My first FNA was done at the hospital (almost passed out by needle #5, nausea, white lights twinkling stars) The second was done by my new endo at his office - he was very good - over & done no problem.
Well, I definately will have a different radiologist doing the fna for the second kick at the can on the 17th as I am going to the other end of the city.. wish me luck this time that I get answers..
No I don't know the numbers..sorry...
COMMUNITY LEADER
My daughter has lupus, so I sympathize with you there. You are right - your symptoms could be attributed to either thyroid or lupus, but I'd lean more toward thyroid, especially with the gravelly voice, etc.
I have osteopenia, too, so that's another one I can identify with. Fortunately, I've been able to rebuild some bone via a regimen of calcium, magnesium and exercise.
Do you know that actual numbers and reference ranges for the FT3 and FT4? Just saying they are "normal" isn't enough, because what's "normal" or "in range" on the lab report, may not be normal for YOU.
I have osteopenia, too, so that's another one I can identify with. Fortunately, I've been able to rebuild some bone via a regimen of calcium, magnesium and exercise.
Do you know that actual numbers and reference ranges for the FT3 and FT4? Just saying they are "normal" isn't enough, because what's "normal" or "in range" on the lab report, may not be normal for YOU.
Well, It's tough when you have lupus also with weird symptoms to consisely say what is attributable to thyroid............I have weird temperature fluctuations. sore throat off and on but like a scalding,throat lymph nodes get sore and hard, weight gain (sudden and not just a little) (could be heart or immune suppressant drugs too), dry skin joint and muscle pain+exhaustion way too disproportionate to activity (but then with the lupus 3rd degree Av block............)gravelly voice....memory issues for years.....I am 52
I have had t3 t4 they are normal...I believe the autoimmune test for hashimotos was neg but he still maintains I likely have it. My calcium tends to be low despite supplemts. I have ospeopenia and broke my ankle in Sept walking down the dry sidewalk...
I have had t3 t4 they are normal...I believe the autoimmune test for hashimotos was neg but he still maintains I likely have it. My calcium tends to be low despite supplemts. I have ospeopenia and broke my ankle in Sept walking down the dry sidewalk...
COMMUNITY LEADER
You said "He thinks I have Hashimotos but wants another tsh..initial one was 8.2 or so and then a month later after fna and aspiration was down to 4. something".
TSH is not going to tell you whether or not you have Hashimoto's; this can only be done with simple antibody tests - TPOab and TGab; I don't understand why he hasn't already done those. You need to have both done because some of us have only one type of antibody - TPOab or TGab; while some have both types. With your nodules, either antibody would confirm Hashi's.
I agree with MANmom - if you have Hashi's, your thyroid is going to stop functioning, eventually, anyway, so either way you look at it, you will be dependent on thyroid hormone replacement.
We are all very different and must make the best decision for ourselves, but if it were me, I'd want to go ahead and get it out, so I could eliminate the worry and wonder about whether or not it's cancer; stress can wreak havoc with thyroid issues. I'd also be able to get the medication I need, and be on the road to recovery sooner.
Your TSH indicates that you are hypo - even "4.something" is too high; is TSH the only test your doctor is doing? You need to have Free T3 and Free T4 tested as well. Those are the active thyroid hormones; without testing for them, you really have no idea whether or not you are hypo. What, if any, symptoms do you have?
TSH is not going to tell you whether or not you have Hashimoto's; this can only be done with simple antibody tests - TPOab and TGab; I don't understand why he hasn't already done those. You need to have both done because some of us have only one type of antibody - TPOab or TGab; while some have both types. With your nodules, either antibody would confirm Hashi's.
I agree with MANmom - if you have Hashi's, your thyroid is going to stop functioning, eventually, anyway, so either way you look at it, you will be dependent on thyroid hormone replacement.
We are all very different and must make the best decision for ourselves, but if it were me, I'd want to go ahead and get it out, so I could eliminate the worry and wonder about whether or not it's cancer; stress can wreak havoc with thyroid issues. I'd also be able to get the medication I need, and be on the road to recovery sooner.
Your TSH indicates that you are hypo - even "4.something" is too high; is TSH the only test your doctor is doing? You need to have Free T3 and Free T4 tested as well. Those are the active thyroid hormones; without testing for them, you really have no idea whether or not you are hypo. What, if any, symptoms do you have?
Hi, the vascularity is a worry. This means it has its own blood supply. Also being doubled in size in 6 months is a concern too.
If you do have Hashimoto's, at some point in the future your thyroid is going to kark it.
I hope the next FNA is the one which clarifies what they are.
If you do have Hashimoto's, at some point in the future your thyroid is going to kark it.
I hope the next FNA is the one which clarifies what they are.
Hi.. Thanks for your comment MANmom...the nodules (5) two good sized ones, are mixed cystic and solid heterogenous lesions measuring 2.0 x 1.1x1.2 cm and 1.6x1.2 x.9 cm some internal vascularity is seen. they are reported to be substantially larger than reported 6 months ago, in fact more than doubled in size. No reference to border appearance. He thinks I have Hashimotos but wants another tsh..initial one was 8.2 or so and then a month later after fna and aspiration was down to 4. something. I think it remains to be seen. please continue to comment anyone who can offer an opinion.. thanks. next fna scheduled with ultrasound Jan. 18th..
You never said (I think, it is late) if the nodules were solid, cystic, vascular, smooth, irregular, etc. Did you get any more information on the ultrasound? If they are vascular, irregular borders, or have calcifications, your chances of cancer increase. If they are smooth and round, with no vascularity, your chances of cancer are less. I had 4 nodules, all were round and smooth, all vascular and varied from 8 mm up to 2.1 cm. I was having hoarseness issues and several other issues, so I had one side removed when they couldn't make a diagnosis. They did find cancer, so I had the additional surgery to remove the rest. Due to the size, tumors over 1.5 cm, I did have RAI 7 weeks later. Do you have Hashi's? If you do, your thyroid will eventually stop functioning anyway, and you can live without it just fine. If they are causing you problems, then you have to mull having them removed and tested.
Saw the endo today and I was to give him my decision regarding what to do now. I opted for door # two which is to repeat the fna to see if something conclusive comes up. I think yanking my thyroid is just not appropriate unless it's deemed malignant at this point and doing nothing and watching and waiting is fool hardy given that I have the gravelly voice, hard sore glands and sore throat off and on. this has been going on for three months. comments welcome
I thought kicking the cat was quite funny! I am a cat lover and could just imagine kicking a sleeping cat would cause all kinds of havoc. Hee hee
That should have read, "kick at the can" and not cat. I have two cats...........sorry fellow animal lovers
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Personally if I were in your shoes I would get another FNA, perhaps from someone a bit gentler! LOL. Inconclusive FNA's are common, it usually means not enough cells to make a decision, too much blood, or cells which look an awful lot like other cells but just can't be sure. Having a thyroid out is a drastic measure and one which needs thorough information before taking that step.
DO make sure it is done with an ultrasound, this is the only way to make sure the needle hits where it is supposed to. I am amazed at how many FNA"s are not done with an ultrasound!
Good luck.