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I Ahd My FNAC Of Neck --it Shows TIRADS 3

Posted on Wed, 22 Jan 2020

Question: I ahd my FNAC of neck --it shows TIRADS 3 solid cyctic nodule in the left lode of thyroid.
Impression : Atypia of undetermined significance, differential diagnosis, hasimotos thyroiditis, Follicular neoplasm, hurthle cel type..
Note:Occasional cells show nuclear atypia( high NC ratio with irregular nuclear membrane, nuclear inclusions and nuclear groves.

Answered by Dr. Bhagyesh V. Patel (26 hours later)

Brief Answer:
long standing pathology altering normal physiology, need further details.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query with attached reports and here is my advise.

* As per my surgical experience, the issue of thyroid homogenous
enlargement both sides with chronic thyroiditis and FNAC changes indicate
long standing pathology altering the normal physiology pattern.

As any report evaluation is incomplete without symptomatic details, kindly provide me further details so that I can answer your query completely.

1. What are your current symptoms , please provide in details.
2. Any difficulty in swallowing, alteration in voice ?
3. Weight loss or gain if any ?
4. Any current medications ?

Awaiting for your response.
Take care.
Dr Bhagyesh ( MS consultant surgeon )

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (15 hours later)

I had felt a swelling near my throat so thought it might be a thyroid issue. That lead me to all these checkups. Before I wasn't having any issues with swallowing or breathing etc..but after FNAC I find pain at my neck, slight breathing issue it's getting better day after day.no issues with voice before or after. And I'm not on medications now. Doctor has suggested for a full thyroid removal.but I need a expert opinion bon this, has any malignancy been detected ??. Should I wait for any further analysis.please suggest

Answered by Dr. Bhagyesh V. Patel (4 hours later)

Brief Answer:
malignancy not detected, but do not delay surgery for long period.

Detailed Answer:
Hi XXXXXXX
Thanks for the details.

* The current FNAC report showing high nuclear cytoplasmic ratio and
irregular nuclear membranes in some cells suggestive of follicular
neoplasm of Hurthle cell type is not clearly indicative of malignancy, but
rather long standing chronic issue of thyroid gland manifested at present
as swelling.

* Malignancy needs capsule invasion and hence FNAC can not differentiate
follicular benign condition towards malignancy precisely in each and every
case.

The advise of total thyroid removal is absolutely indicated in your case as per guidance of your consultant because of following reasons :

1. There is no medical cure available for your condition, as remedy in terms
of medicines to resolve it.
2. There are remote chances that current benign condition may turn out to
be cancer in future if left as such for long period of time.
3. You will get definite pathological diagnosis after biopsy report of the
whole thyroid gland after surgery.

* You do not need any further evaluation except routine pre op reports of lab
and anesthetic fitness evaluation by expert physician.

Let me know if you have further doubts anytime.
Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (15 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Hi

* The usual course of stay in hospital is around 3-4 days on average and post
operative recovery requires at least a break of 15 days from job work.

As there is family history of Hodgkin lymphoma, surgery is a must consideration for you, though not emergency but earliest at planned situation.

Wish you best recovery from current health concern.
Regards.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Bhagyesh V. Patel (21 minutes later)

Thank you so much for the guidance and support.

Will surely go ahead with it.

Follow up: Dr. Bhagyesh V. Patel (1 minute later)

What would be the recovery time after the surgery.as I'm currently working now so that I can convey it to my higher authorities.when can I switch back to my regular activities as I have a 1.5 year old baby to take care of. Pls suggest

Follow up: Dr. Bhagyesh V. Patel (2 minutes later)

I lost my mother to non Hodgkin lymphoma 2 years back.so Im lil concerned with my present issue.