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Treated For Thyroid Surgery, Biopsy Shows Thyroid Nodule, Suggestive Of Hyalinising Trabecular Adenoma With Follicular Variant Of Papillary Carcinoma
Question: Sir,
My wife was treated for thyroid surgery.
I submit herewith the BIOPSY REPORT given by the XXXXXXX diagnostic centre. Pl peruse and advise us the next course of action.
Biopsy No. 3727 / HPE / 2012
Nature of Specimen : Hemi-thyroidectomy
Clinical details : Not provided
Gross : Received one labelled bottle with hemi-thyroidectomy specimen measuring 6 x 4 x 3.5 cms.
Surface smooth. Cut section shows well circumscribed nodule (grey XXXXXXX with areas of hemorrhage)
and measuring 4.8 x 3.3 cms.
Sections for histology : A,B,C,D,E,F (Part embedded)
Microscopic Examination :
Section shows thyroid nodule containing compactly arranged acini lined by cuboidal epithelium.
Focal areas show cribriform pattern and trabecular arrangement. Nuclei show ground glass appearance.
There are islands of cubocolumnar cells with elongated nuclei with nuclear grooves and ground glass
appearance. Cells are arranged in trabecular pattern with areas of hyalinisation. No capsular invasion
or vascular infiltration. Adjacent thyroid tissue show focal lymphocytic collections.
Impression : Suggestive of HYALINISING TRABECULAR ADENOMA WITH FOLLICULAR
VARIANT OF PAPILLARY CARCINOMA
* Advised - Immuno-Histochemistry
Pl advise whether we have to go for surgery or radio iodisation treatment or any other?
My wife was treated for thyroid surgery.
I submit herewith the BIOPSY REPORT given by the XXXXXXX diagnostic centre. Pl peruse and advise us the next course of action.
Biopsy No. 3727 / HPE / 2012
Nature of Specimen : Hemi-thyroidectomy
Clinical details : Not provided
Gross : Received one labelled bottle with hemi-thyroidectomy specimen measuring 6 x 4 x 3.5 cms.
Surface smooth. Cut section shows well circumscribed nodule (grey XXXXXXX with areas of hemorrhage)
and measuring 4.8 x 3.3 cms.
Sections for histology : A,B,C,D,E,F (Part embedded)
Microscopic Examination :
Section shows thyroid nodule containing compactly arranged acini lined by cuboidal epithelium.
Focal areas show cribriform pattern and trabecular arrangement. Nuclei show ground glass appearance.
There are islands of cubocolumnar cells with elongated nuclei with nuclear grooves and ground glass
appearance. Cells are arranged in trabecular pattern with areas of hyalinisation. No capsular invasion
or vascular infiltration. Adjacent thyroid tissue show focal lymphocytic collections.
Impression : Suggestive of HYALINISING TRABECULAR ADENOMA WITH FOLLICULAR
VARIANT OF PAPILLARY CARCINOMA
* Advised - Immuno-Histochemistry
Pl advise whether we have to go for surgery or radio iodisation treatment or any other?
Dear Mr. XXXXXXX
Thanks for your query. I have gone through the reports.
Firstly you need to have second opinion from a different pathologist on the biopsy report of your wife. We need to be doubly sure about the report which is crucial for taking treatment decisions.
Secondly your wife need to have radioisotope scan of the neck and whole body to check for any residual disease in the thyroid and any metastatic spread in the lymph nodes or other body parts.
As per the description of the biopsy slide, the tumor is more of benign nature and you can remain under observation for the time being. There is no need for active treatment or intervention.
Further management will depend on the radioisotope scan report. Please follow with your treatment center and follow with me so that you are on the best line of management.
I can assure you that prognosis of your wife is very good. I will be happy to respond to your further queries if any.
Truly,
Dr. J. Ticku
Thanks for your query. I have gone through the reports.
Firstly you need to have second opinion from a different pathologist on the biopsy report of your wife. We need to be doubly sure about the report which is crucial for taking treatment decisions.
Secondly your wife need to have radioisotope scan of the neck and whole body to check for any residual disease in the thyroid and any metastatic spread in the lymph nodes or other body parts.
As per the description of the biopsy slide, the tumor is more of benign nature and you can remain under observation for the time being. There is no need for active treatment or intervention.
Further management will depend on the radioisotope scan report. Please follow with your treatment center and follow with me so that you are on the best line of management.
I can assure you that prognosis of your wife is very good. I will be happy to respond to your further queries if any.
Truly,
Dr. J. Ticku
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
sir,
one of our surgical oncologist Dr. XXXXXXX GOUD working at KIMS, HYD advised us radioiodine ablation of remaining thyroid tissue instead of doing surgery again. after cosulting the doc at radiotherapy dept. , she said that they wil do radioiodine scan after 6 months of giving dose for RI ablation, and she needs regular follow up in future.. can we go with this procedure? pls guide us sir..
one of our surgical oncologist Dr. XXXXXXX GOUD working at KIMS, HYD advised us radioiodine ablation of remaining thyroid tissue instead of doing surgery again. after cosulting the doc at radiotherapy dept. , she said that they wil do radioiodine scan after 6 months of giving dose for RI ablation, and she needs regular follow up in future.. can we go with this procedure? pls guide us sir..
Dear XXXXXXX
Yes, that is the right advice but the need for surgery would depend upon the report of the radioiodine uptake scan, if any residual disease or metastasis is found. Your wife might not need any more surgery. After Radioiodine ablation, she will need replacement therapy as well. Follow up with your surgeon with intimation to me, but have the uptake study done first.
I am again letting you know that your wife has good prognosis.
Best of luck
Dr. Ticku
Yes, that is the right advice but the need for surgery would depend upon the report of the radioiodine uptake scan, if any residual disease or metastasis is found. Your wife might not need any more surgery. After Radioiodine ablation, she will need replacement therapy as well. Follow up with your surgeon with intimation to me, but have the uptake study done first.
I am again letting you know that your wife has good prognosis.
Best of luck
Dr. Ticku
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Aparna Kohli
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