FNA results - Follicular Neoplasm. Help?!

Hi Shelly!

Thanks for the quick response. I was hoping after my Fine Needle Aspirate I'd have all my answers and this would be over! Unfortunately, that's not the case and more tests need to be done. Is it normal to do the thyroid scan after an FNA? Or is it just a measure of triple checking? I always thought FNA's were the only test to definitively announce cancer or not (of course, aside from surgery itself).

Hello Andrea:

There are scans that have iodine uptake which show the thyroid function.

Also they have scans with a dye that can show if something is cancer or not.  Some also are imaging dyes that show better pictures og the nodule.

Oh very normal to do these scans after a FNA or biopsy.  They can be done first or second. 

I have 3 nodules under 1 inch and I am 55 and still kicking!  LOL. 

Keep me posted on how you do, any questions just ask.

Shelly

I've kind of read up a little bit on the iodine scans, but do the cancer cells show up on the scan? Or if they don't show up, then there is no cancer cells?

Also, if the scan still can't tell whether it is a type of cancer or not, do they suggest surgery? I'm not sure if the size of mine can be taken into account for surgery or not, regardless of outcome.

Hello Andrea:

Yes, Iodine ones are for thyroid function.  The cancer scans use a certain dye that cancer cells bind to & it picks up cells and they can see it on imaging. They can see a lot.

If no cancer no cells will pick up the dye.  They do not remove nodules unless they are pressing and causing breathing problems or making your thyroid big and causing a goiter.  If they did surgery they would have to remove the lobe the nodule would be on and you have 2 lobes but that is not the case for most of us. Of course that may make you more Hypothyroid. 

Since your nodule is large 4 cm  by 2 cm and, (2,54 =1 inch ) so it is a good idea to check it very throughly because it is over 1 inch.

It could just be a big clump of lymph tissue.  Some people even have fluid filled ones.   How long have you had it?

Any questions just ask,

Shelly

Thank you for clarifying that!

I've read online about "hot" and "cold" nodules. Would a cold one not show up on the scan, as opposed to a hot one? And also, hot would suggest benign right?

My doctor had really stressed to me that they're just making sure it's nothing serious, so I'm grateful for that!

I have had my nodule for 4 months. I discovered it while looking in the mirror in December.

Hello Andrea:

Yes, Cold ones tend to be cancer.  Hot ones tend to be benign.  All nodules show on an Ultrasound and if certain dye is used on a scan they can see if it picks it up esp. cold ones. Imaging today can detect so much and is a valuable diagnostic tool. Lucky we live in modern medical times.

I think because of the size of your nodule it is wise to go a step more and see what is what and look at it more closely.  If it goes bigger than an inch they do it. It is protocol since size matters with nodules.

Also now that you will have this done, you will have a baseline and if needed they may want to scan or Ultrasound it to check it if they feel it should be maybe once a year.   I do that fo rmy 3 nodules that are in my thyroid but mine are under 1 inch.  It is always wise to keep an eye on them.

As long as you can breathe and swallow okay and no other blood work is off, things should be okay. 

Do keep me posted on what happens.  I care!

Shelly

My doctor has asked me if it's gotten larger in the 4 months and I can't tell if it had. Some times I ask myself how I ever lived without noticing it, since it's so obviously visible! After my FNA was done, it's seemed to become larger to the touch (but could just be irritated I guess from the procedure). It was about 2 and a half weeks ago now.

I don't have troubling swallowing or breathing, but very often I feel like I can't swallow my saliva fully. Almost as if it just gets stuck at the back of my throat. Not sure if it's related (and it's not life threatening, just bothersome!).

And we did check my thyroid levels and everything came back normal as well.

Hello Andrea:

Sometimes the nodule can have a mix of solid & cellular type fluid deep inside and sometimes they swell after the FNA.  You have not had it for years which is good.

The bad thing is you have the annoying feeling at your throat, and that of course goes with it's size. Like I said size matters with nodules and cysts. 

Oh that is good that your thyroid levels are okay, because very often the thyroid gets bothered by the large nodule and normal TSH levels  can change.

When is your scan scheduled for?  Keep me posted on what they say,

Shelly

Just got off the phone with the endocrinologist - their earliest available appointment is August 12th. I'm pretty upset that I have to wait this long, but I understand they're very busy people with a lot of clients.

I believe he'll be the one in charge of scheduling my scan, so that probably won't happen until September, if not October. I'll do my best to come back and post on the forum!

Hello Andrea:

You can ask to be on a wait list in case someone cancels and you could take their appointment, so call them abck and ask for that.  Also ask your GP if he or she has any pull in getting you an earlier appointment.

Many people do cancel and it is always worth a try to be on a wait list.

XO, Shelly

Hello Annette:

Are you able to swallow okay and any problems with that?  Is it harder for you to breathe or does it press on your neck  too much?

Size matters with nodules as we do not have a lot of room around our neck to accomodate big nodules and they press on the throat a lot.

I know you had the Ultrasound & FNA and what did they advise you about living with this?

Shelly

Hi Shelly,

Ive been to see the Consultant today as urgent because the nodule seems to have got slowly bigger over the past month.  Examination showed yes the nodule is bigger than last time but at present there isnt a problem with swallowing and breathing.  The Consultant did say that sometimes within the cyst there can be a small amount of bleeding which can make the nodule grow more so i have been scheduled to have another FNA in the next few weeks and scan and then see what happens.  I know that treatment can be good these days but I think because of where the lump is (neck area) it is more worrysome so I can relate to how you are feeling.  Its on my mind 24/7 I just wish it would go away !!!, always here if you want to keep in touch.  If you feel it gets worse, going on the cancellation list is a good idea, good luck Annette.

Hello Annette:

Yes, some nodules have a bloody fluid called serous fluid in them and it can expand. The good news is they can be drained and then it will settle down.

I would do the FNA and not cancel at all.  It is scary but many people get them.  As long as you can breathe and swallow okay that is first. 

Some time back a young gal on here had a big cystic nodule & she was worried and just starting college and they drained her and she was fine.

Please see if they can wait list you  for a person who cancels and get seen sooner.  If you ever feel you can't breathe or can't swallow you contact the nearest A &E facility.

Keep me updated and I am praying for you to have a good outcome.

Shelly

Hi Shelly

Its so kind of you to offer your time in helping us, I feel better talking with lovely people like you and makes me feel that im not alone with this.  Its a strange thing but over the last few days my lump is still there but doesnt feel so aggressive so im hoping that the maybe blood in the cyst may have dispersed because my diagnosis is a celloid cyst sorry spelling may be wrong here......... im on waiting list for a scan and FNA, if that comes back clear would you opt for surgery thats the question...........i can breathe ok for now but if the lump getts bigger with the waitig list here it may be worth going for surgery incase i do get problems in the future.  I live in wales UK and the NHS is suffering xx

Hello Annette:

I know how scary it is being a patient also. Even Nurse's and doctors get ill. So helping someone with knowledge is very important and if I can help I will.

Surgery for a nodule or cyst is only really done if you are having swallowing problems and or breathing problems from it.  If they took it out via surgery they may have to remove a LOBE of the thyroid gland that it is on, which would cause your body to only have half thyroid. 

Some people can live fine with 1/2 of it but some get Hypothyroid from it and would then need to take medication to replace the hormone if needed.  Of course it would remain to be seen, if the other half would make enough for your body.

Cysts can be drained by a needle aspiration and then they heal after that.  So if you can let them see if it can be drained first.  If you can breathe okay and swallow food okay, then leave it alone.  The scan will tell us so much more about what it is, so let's do that of course. 

Cells in our body make a fluid that is blood mixed with a clear cellular fluid and they can swell up like water in a balloon.  Some cysts can be from an infection and form that way.

Surgery can be done if the cyst is very dense or has bad characteristics. I would opt for the scan and perhaps have it drained first by FNA.

If you have any questions just ask, Keep me updated.

Shelly

Hi shelly

Thanks again for your reply, it does help a lot.  Yes I will see what the scan shows, they wernt able to drain it last time, it was too sticky but maybe there is a mix of fluid there also.  My doctor suggested surgery because of its size so will see what the scan shows.  Its a shame they cant just take away the cyst without touching the thyroid, I would have peace of mind if it went because we have long waiting lists to get into hospital and I dont want to wait until it gets to be a problem so I will keep you updated and best of luck to you 

Annette