QUESTION: I recently had a FNA of a nodule (1.6 x 1.7 x 1.7cm). The pathology report seems vague and I wondered if you could define the findings for me: Bland Follicular epithelium in a background of dense colloid. Comment: Given the relative cellularity and scant colloid, the findings are consistent with a cellular nodule. This finding could be seen in a follicular neoplasm or a cellular goiter. The risk of neoplasm is considered to be moderate with a low risk of follicular carcinoma. No evidence of papillary thyroid carcinoma is seen.
It's not saying, definitively, if this nodule if benign or not. Any input would be greatly appreciated.
ANSWER: Hello Kathy:
Given the findings in the smear it is definitely NOT papillary thyroid cancer (commonest type of cancer in thyroid).
It is a colloid nodule with normal appearing follicular epithelial cells (cells that line the gland/ follicles in the thyroid) These secrete a proteinaceous material called colloid and produce the thyroid hormones.
A solitary nodule can be a follicular neoplasm - these are benign if there is no invasion of the capsule (fibrous tissue surrounding the nodule. If the invasion is seen it is considered a follicular cancer of thyroid. This can only be confirmed if the nodule is removed. Based on clinical features, your thyroid hormone profile, your doctor will be able to decide whether to go for excision of nodule or not.
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QUESTION: Based on this response, my question would then be: can the interference of a nodule on the thyroid throw off the "balance" of the thyroid? My blood work reads as follows: TSH 2.18; and the Free T4 is 0.94. I have gained, rapidly, about 8 lbs and am curious if this could be part of the problem.
Again, may thanks - this service is beneficial
Majority people with colloid nodule have normal thyroid function tests. Your TSH and FreeT4 values are within normal range for now.
If the TSH falls below normal range you may develop hypothyroidism. Subclinical hypothyroidism presents with weight gain and fatigue.
You can have the thyroid function tests repeated in 6 months to review the levels