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What Does A Follicular Lesion Of Undetermined Significance Mean?

Posted on Wed, 10 May 2017

Question: What does a follicular lesion of undetermined signifigance mean? Then states a differential diagnosis of follicular neoplasm. I have had half of my thyroid removed 5 years ago because of atypical cells now 2.5 cm growth on other side. Had biopsy they sent it off for a second opinion both are in determinate second coming back as what I stated in beginning of question. Most things I can figure out. Just not the verbiage on my secon opinion. Over two weeks since my biopsy and I have significant swelling since biopsy went back for second US two days ago and it did not show hemorrhage but I know what I feel. This is all so different from any other experience I have had with my thyroid. It's like the biopsy made it angry!

Answered by Dr. Hari Charan Perigela (7 hours later)

Brief Answer:
The diagnosis is not clear.

Detailed Answer:
Hi
UNDETERMINATE means the pathologist can't say whether the lesion is benign or malignant.
As the lesion is present in the lobe,entire lobe has to be removed and send the specimen for histopathological examination.
Swelling could be due to injury during Biopsy.As Thyroid is vascular, increase in size of the lesion/gland can be seen.It is not of much concern until it becomes very big causing respiratory embarrassment.
I prefer to remove the entire lobe and proceed further based on Biopsy report.It could be Benign too.
Nothing to worry.
Hope I answered your query.If you have any questions, I will clarify further.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Hari Charan Perigela (9 minutes later)

What about the differential diaganosis of follicular neoplasm?

Answered by Dr. Hari Charan Perigela (2 hours later)

Brief Answer:
It could be Benign or Malignant.

Detailed Answer:
Hi
Follicular Carcinoma is diagnosed by Biopsy only ,not by FNAC.To say it as a Follicular carcinoma,there should be Capsular invasion or Angioinvasion which cannot be made by FNAC.
If he Pathologist cannot differentiate an Adenoma from Carcinoma,he will write as Follicular neoplasm.
As the lesion is confined to one lobe,it is better to get it excised completely, send for histopathological examination and confirm the diagnosis.
Hope I answered your query.
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Hari Charan Perigela (51 minutes later)

Yes you answered but i only have the one half left so i didnt know if they still proceed like they did they first surgery. Since i will be losing the rest of my organ that means meds for the rest of my life i assume procedure is procedure regardless of having half of all of thyroid,

Answered by Dr. Hari Charan Perigela (4 hours later)

Brief Answer:
You should be operated.

Detailed Answer:
Hi
The remaining lobe has to be removed as there is a nodule in it.
You will be kept on Thyroxine tablets.
We prescribe Thyroxine tablets to many patients with Hypothyroidism. Do not worry about prolonged usage.
Hope I answered your query.
Regards

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Above answer was peer-reviewed by : Dr. Kampana