AboutNeha Dahiya MD Expertise I can help patients understand their lab report results, help them with queries regarding what pretest prepration is required. How often a follow up test needs to be done. What does a particular tissue biopsy report mean in everyday english. I can explain the biopsy or cytology procedure. I can deal with Histopathology / cytology / clinical pathology and clinical chemistry queries. Helping in this manner will be my contribution to the community.
Experience I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multispecialty hospital laboratory.
Organizations Indian association of pathologists and microbiologists.
MIAC - Member International Academy of Cytology
International association of Pathologists - indian division
Indian association of Cytology
Question QUESTION: I am a 41 yr old female. I recently went to my GYN MD for routine appt. She found that my thyroid was enlarged. I've not had any symptoms, but had an uncle [on my father's side] and aunt [on my mother's side] with Thyroid cancer.
Not sure what types.
Had an ultrasound with the findings below:
Rt lobe: 6x2.2x1.8 cm inhomogenous lobe. Focal, superior pole anterior is hypoechoic round lesion, 7mm at greatest diameter. Second area isoechoic round lesion in mid lobe 1.8 cm greatest diameter with partial halo. Third area hypoechoic 8mm greatest diameter with some through sound transmission; inferiorly lobulated hypoechoic exhibiting through sound transmission that is 1.2 cm at greatest diameter.
Lt lobe: inhomogenous lobe 5.3 x 1.7 x 1.8 cm. Dominant isoechoic, heterogenous nodule in mid anterior gland with partial halo, 2.1 cm; inferiorly, lesion with similar characteristics inferiorly that is 1.7cm at greatest diameter.
FNA results:
Rt: colloid and thyroid follicle cells, consistent with colloid/adenomatous nodule.
Lt: group of thyroid follicle cells with nuclear atypia and focal Hurthle cell changes.
Cytology suggestive of follicular lesion, possibly follicular adenoma or *adenomatous nodule*.
Malignancy cannot be excluded on the basis of fine needle aspiration in follicular lesions.
The above was the preliminary reading by the pathologist, while cell blocks were pending. After cell blocks results, they omitted the starred item above.
I'm scheduled for partial/possible total thyroidectomy on Thursday. Can you give me an idea of what the above means? Do you feel it may just be Hashimoto's or other?
Thank you for any feedback you can give.
ANSWER: Hello Cheryl:
The FNA report after the cell block interpretation indicates that the thyroid possibly has a follicular adenoma. Which means it is a nodule of overgrowth of thyroid tissue arranged as glands.
However on FNA it is difficult to say if the nodule is just a benign overgrowth or a cancerous overgrowth. For this reason a thyroidectomy is important. The path exam following that will give a definite diagnosis.
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QUESTION: Thank you.
What do the hyper/hypo/isoechoic terms mean? Also, is the halo a good thing?
I forgot to mention that my TSH was normal.
I'm wondering what the chances of all this being a malignancy are.
Thank you, Cheryl
Answer Hi:
These terms are better explained by a radiologist. In ultrasound, the images are obtained by sound waves hitting and passing through different areas and they get deflected in different manner producing hyper / hypo or isoechoic patterns.
Trying to estimate chances of malignancy with this limited knowledge is like speculation. Only histological examination can give a definitive answer.
