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What does subcapsular area in a lobectomy pathology report mean?

Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Tue, 7 Jun 2016 in Thyroid Problem and Hormonal Problems
Question: Dear Dr.

I have been recently done Right Thyroid Lobectomy due to nodule sized 1.6 x 1.3 cm after (2) FNAB resulted FLUS and suspicious for follicular neoplasm respectively.

The lobectomy pathology results are:

- Multinodular Goiter

- Incidental Papillary Micro-Carcinoma, follicular variant, Infiltrative

- Maximum tumor of Micro-Carcinoma is 3 mm

- Micro-Carcinoma appears as singal focus in the subcapsular area (2mm from the capsule) with intratumoral fibrosis

- all resection margins are free

- Remaining thyroid parenchyma shows minimal lymphocytic thyroiditis changes.

My questions:

1. Does the follicular variant behave similar to Papillary thyroid cancer or follicular thyroid cancer?

2. what does subcapsular area means?

3. what does intratumoral fibrosis means?

4. what does lymphocytic thyroiditis changes means? does lymphocytic thyroiditis cause hyper or hypo?

5. Does lymphocytic thyroiditis cause thyiod cancer?

6. what is the treatment for the lymphocytic thyroiditis?

7. I have biltarel enlarged lymph nodes in levels IB, II, III, IV and the largest ones in level IB and II. Could it be metastatic lymph nodes from my thyroid cancer?

8. which one more reliable in finding nodules in thyroid, CT Scan or US? Several US exams have been done and all showed there is NO nodules in the left lobe. However, (2) CT sacns have been done and showed nodules in the left lobe. My doctors told me US is more sensitivethan CT in thyroid !

9. Do you think I should go for left lobectomy and neck dissection? or yearly follow-up is ok?

10. Can thyroid cancer spread to Jaw, base of tongue and salivary glands under the tongue?!
Clarifications:

I am being seen by ENT Surgeon and Endocrinologist only. Do I need to be also seen by Oncologist?
Thank you very much for your time and response.
doctor
Answered by Dr. Shehzad Topiwala 10 hours later
Brief Answer:
Thyroid

Detailed Answer:
1. Does the follicular variant behave similar to Papillary thyroid cancer or follicular thyroid cancer?

Follicular variant of Papillary Thyroid Cancer (PTC) behaves similar to PTC except they tend to be smaller and chance of spreading to nearby lymph nodes is lesser


2. what does subcapsular area means?

Just beneath the capsule

3. what does intratumoral fibrosis means?

fibrosis inside the tumor. Fibrosis means hardening and tightening up and often shrinking

4. what does lymphocytic thyroiditis changes means? does lymphocytic thyroiditis cause hyper or hypo?
there is a type of white blood cell called lymphocyte. They arrive in large numbers inside the thyroid to cause bruising. It typically leads to an under-active thyroid ('hypothyroidism')


5. Does lymphocytic thyroiditis cause thyiod cancer?

Not typically but a very small risk of developing a lymphoma is there

6. what is the treatment for the lymphocytic thyroiditis?

if the TSH rises , it indicated the thyroid is not making adequate amounts of thyroid hormone and replacement with levothyroxine becomes necessary

7. I have biltarel enlarged lymph nodes in levels IB, II, III, IV and the largest ones in level IB and II. Could it be metastatic lymph nodes from my thyroid cancer?
To get a fair idea regarding this, an FNAB of those lymph nodes is helpful


8. which one more reliable in finding nodules in thyroid, CT Scan or US? Several US exams have been done and all showed there is NO nodules in the left lobe. However, (2) CT sacns have been done and showed nodules in the left lobe. My doctors told me US is more sensitive than CT in thyroid !

Ultrasound


9. Do you think I should go for left lobectomy and neck dissection? or yearly follow-up is ok?

This is something to be discussed by you and your doctors in-person weighing multiple facts and findings on physical examination

10. Can thyroid cancer spread to Jaw, base of tongue and salivary glands under the tongue?!
It can but generally when it spreads locally it is typically in the area of the food pipe or wind pipe area or voice box nerves or spinal cord
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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