adenoma

[spudsmam]

I think I was misdiagnosed 8yrs ago when I had my daughter I had all symptoms of hypothyroid disease, but was told it was post partum depression. I insisted on tests at the time, My thyroid tests all normal. I had an ultrasound which showed a nodule on the right that was too small to biopsy. I had looked up at the time the characteristics of the nodule and it appeared to me to have some malignancy signs. Today after suffering with hair loss, fatigue, low enerygy, low libido, migraines, sinus drainage, ear fullness, enlarged axillary lymph nodes at times, , weight gain, laziness, sore throat, hoarseness, and other symptoms, I went and had test done, again thyroid test normal, ultrasoudn showed the nodule from 2005 increased in size 50% . Had an ultrasound guided biopsy showed a thyroid adenoma. My question is can this be cancer. The ENT guy did not say if it was he did say that the cytology did not show any malignant looking cells. I read that the adenoma could possibly still be malignant because the cytology did not use the central core of the adenoma. Should I pursue this and ge t a second opinion?

[jekuter]

I think I was misdiagnosed 8yrs ago when I had my daughter I had all symptoms of hypothyroid disease, but was told it was post partum depression. I insisted on tests at the time, My thyroid tests all normal. I had an ultrasound which showed a nodule on the right that was too small to biopsy. I had looked up at the time the characteristics of the nodule and it appeared to me to have some malignancy signs. Today after suffering with hair loss, fatigue, low enerygy, low libido, migraines, sinus drainage, ear fullness, enlarged axillary lymph nodes at times, , weight gain, laziness, sore throat, hoarseness, and other symptoms, I went and had test done, again thyroid test normal, ultrasoudn showed the nodule from 2005 increased in size 50% . Had an ultrasound guided biopsy showed a thyroid adenoma. My question is can this be cancer. The ENT guy did not say if it was he did say that the cytology did not show any malignant looking cells. I read that the adenoma could possibly still be malignant because the cytology did not use the central core of the adenoma. Should I pursue this and ge t a second opinion?

Hey. Well first of all you must know that the presence of NORMAL thyroid hormone levels do not differentiate a benign nodule from a cancerous one.

Second , a usually hyper-functioning or hypo-functioning nodule ( in other words hyperthyroidism or hypothyroidism ) favor the nodule as being benign in most of the cases.

Third, Ultrasound accurately determines thyroid gland volume, number, and size of nodules, separates thyroid from nonthyroidal masses But
the only definite way is thyroid FNA (fine needle aspiration) biopsy. Ultrasound may miss some of the cancerous growths.

I would recommend you get FNA done on the nodule, because in 99% of the cases it is accurate in determining a malignant nodule from benign one. A thyroid adenoma can be malignant if it has malignant cells.

[spudsmam]

I had the ultrasound guided fine needle biopsy which showed" uniform follicular cells in monolayers are seen in thin colloid. Reactive and degenerative changes are present. No cystic changes or nuclear atypia are seen. The cell block sections show rare follicular cells." Should I have this thyroid removed. It has been there probably over 5 years. I am concerned because the right axillary lymph node swells on and off. I read that FNA can not tell whether a follicular adenoma is malignant or benign. It need s to be removed and studied under a microscope.

Hey. Well first of all you must know that the presence of NORMAL thyroid hormone levels do not differentiate a benign nodule from a cancerous one.

Second , a usually hyper-functioning or hypo-functioning nodule ( in other words hyperthyroidism or hypothyroidism ) favor the nodule as being benign in most of the cases.

Third, Ultrasound accurately determines thyroid gland volume, number, and size of nodules, separates thyroid from nonthyroidal masses But
the only definite way is thyroid FNA (fine needle aspiration) biopsy. Ultrasound may miss some of the cancerous growths.

I would recommend you get FNA done on the nodule, because in 99% of the cases it is accurate in determining a malignant nodule from benign one. A thyroid adenoma can be malignant if it has malignant cells.

[jekuter]

I had the ultrasound guided fine needle biopsy which showed" uniform follicular cells in monolayers are seen in thin colloid. Reactive and degenerative changes are present. No cystic changes or nuclear atypia are seen. The cell block sections show rare follicular cells." Should I have this thyroid removed. It has been there probably over 5 years. I am concerned because the right axillary lymph node swells on and off. I read that FNA can not tell whether a follicular adenoma is malignant or benign. It need s to be removed and studied under a microscope.

Yes since they are follicle cells, FNAC will not distinguish from cytology the potential for malignancy or benignity. You need to get a sample removed and get it sampled for Vascular invasion and capsular integrity to make sure its just benign.
I might add Follicular cancers tend to spread by bloodstream, and not lymph nodes, so your lymph node enlargement may not be due to follicular nodule if indeed its a follicular nodule.
I would definitely get it removed for histopath diagnosis. Good luck !

[spudsmam]

Yes since they are follicle cells, FNAC will not distinguish from cytology the potential for malignancy or benignity. You need to get a sample removed and get it sampled for Vascular invasion and capsular integrity to make sure its just benign.
I might add Follicular cancers tend to spread by bloodstream, and not lymph nodes, so your lymph node enlargement may not be due to follicular nodule if indeed its a follicular nodule.
I would definitely get it removed for histopath diagnosis. Good luck !

Thank you for your advise. I have an endo appt in March. I also want to get a second opinion of the slides.