Pathology/fna biopsy report

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Question
Needing some advise the pathologist said remove thyroid my surgeon says I can wait and keep eye on it or just remove nodule here is what the fna report says .the findings are suspicious for but not diagnostic of a follicular neoplasm ,excursion is recommended.  Cytologic evaluation of the aspirate smears show abundant follicular cells in predominantly micro follicular arrangements, crowded three- dementional clusters, and trabecular arrangements. The nuclei are enlarged and are occasionally nucleolated . scant dense colloid droplets are noted in the background . follicular variantof papillary carcinoma is not excluded.

Answer
Hello Kelly:

I apologize for the undue delay in response to your question. Some how the email got sent to the spam folder.

Follicular neoplasm means presence of a growth having a follicular pattern. The thyroid cells arrange themselves around a central space to form a follicle.

On FNA it is very hard to conclude  if the follicular neoplasm is benign or cancerous. To make a diagnosis of follicular cancer you have to see invasion of cells into the capsule (fibrous stands covering the lesion) or blood vessels. This cannot be ascertained from the few cells seen on an FNA smear. Hence only way to confirm this is by excising the nodule.

Having said that many such lesions post surgery may turn out to be benign. You could wait or opt for surgery for your peace of mind. The choice should be yours.

Pathology

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Neha Dahiya MD

Expertise

Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.

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 multi specialty hospital laboratory in India.

Organizations
Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

Education/Credentials
MD (pathology) MBA

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