Expert: Karen Brawner - 2/17/2004

Question
I have two nodules on my thyroid, one tiny, and the other 2.3cm. Antithyroglobulin level is above 700, but thyroid hormones are normal. I am also experiencing intermittent pain in the thyroid as well as in the side of my neck, and in the muscles near my collarbone.  A Fine needle aspiration shows: 'Few groups of follicular cells and Hurthle cells present in a background with numerous macrophages. The morphologic features are most consistent with nodular goiter.' My Dr. said it is a benign report, but the other info. I've read says diagnosis is not that simple. Can Hurthle cells be ruled for certain as benign from a FNA?
Thanks, Cheryl  

Answer
Dear Cheryl,    FNA are not accurate all the time....  Infact, there are 2 types of thyroid cancer that usually a FNA can not determine.....  This is why most all doctors prefer to surgically remove the thyroid gland these nodules are connected to and do a COMPLETE tissue biopsy....

No, Hurthle cells can not be ruled for certain from a FNA.. The only way to know for SURE if anything is benign is to have it completely removed and biopsied...  A FNA will NOT tell if there is any invasion or for sure if this condition is benign....

Since you are having pain, I would suggest to be on the safe side, that you get a second opinion from a SURGEON.... This surgeon can be an Endocrinologist/Surgeon or a General Surgeon...  

Here is a web site that will give you a LOT of information about the thyroid, cancers, and Hurthle cells...

www.endocrineweb.com/hurthle.html

Thank you,   karen