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What Does This FNAC Report Showing Thyroid Neoplasm Indicate?

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Posted on Mon, 23 Jun 2014
Question: Hi . I got my Fnac for right lobe of the thyroid.

Microscopic finding: moderately cellular smears showing follicular epithelial cells in small groups and acini. Background showed a few pigment laden macrophages.

Imperssion: features are suggestive of thyroid neoplasm.

Does this indicates malignancy . Please advise required treatment.



doctor
Answered by Dr. Deepika Patil (2 hours later)
Brief Answer:
could be malignancy; but not definitive..

Detailed Answer:
Hi XXXXXXX

FNAC usually don't give 100% accurate results. It's accuracy is 90 to 92%.

Further your FNAC findings are not specific. They could be seen in both malignancy or non malignant conditions. The important FNAC finding of malignancy is vascular invasion (malignant cells in vessels) which is not mentioned in your fnac report.

However generally the chances of malignancy is high if the patient is:
- male,
- age is less then 40yrs,
- Increased vascularity
- Enlarged lymph nodes,
- it is cold nodule
Since you are a male under 40 years of age, this mass lesion should be looked under suspicion.

If a patient comes to me with such a situation I usually suggest them to undergo surgery. In surgery I confirm malignancy by frozen section. Here the tissue is studied immediately after removing from body and results will be given in 15 to 20 mins . After that I proceed for total removal of thyroid gland . Next step will be removal of lymphnode after confirming spread to them by frozen section.

After histopathology report which takes 4 to 5 days to come I usually decide to give thyriod supplements and radio iodine ablation or not.

The results of sugery for thyroid malignancy are good and survival is not affected by this malignancy as it is less aggressive and slow growing and slow spreading malignancy.

You can consult a cancer specialist surgeon.

Hope I have answered your query . If any further queries are there I would love to help .

Regards
Dr.Deepika Patil

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Deepika Patil (23 hours later)
In my case what percentage of biopsy will result in malignancy . Also which type of thyroid cancer and possible the stage as well.
doctor
Answered by Dr. Deepika Patil (34 minutes later)
Brief Answer:
95-98% chances of malignancy

Detailed Answer:
Hi XXXXXXX

In your case the chances of biopsy turning out to be malignancy is as high as 95-98%. Because benign conditions won't spread to lymph nodes.

As fnac has shown follicular cells the most common carcinoma arising in it is "Follicular carcinoma" of thyroid.

Follicular carcinoma in patients under 45yrs have only 2 stages. Stage 1 and 2 depending upon distant spread. As you don't have distant spread you fall under stage 1. This stage is fairly curable if treated early.

Hope I have been helpful. If any further queries are there I would love to help .

Regards
Dr.Deepika Patil
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Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Deepika Patil

General Surgeon

Practicing since :2008

Answered : 745 Questions

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What Does This FNAC Report Showing Thyroid Neoplasm Indicate?

Brief Answer: could be malignancy; but not definitive.. Detailed Answer: Hi XXXXXXX FNAC usually don't give 100% accurate results. It's accuracy is 90 to 92%. Further your FNAC findings are not specific. They could be seen in both malignancy or non malignant conditions. The important FNAC finding of malignancy is vascular invasion (malignant cells in vessels) which is not mentioned in your fnac report. However generally the chances of malignancy is high if the patient is: - male, - age is less then 40yrs, - Increased vascularity - Enlarged lymph nodes, - it is cold nodule Since you are a male under 40 years of age, this mass lesion should be looked under suspicion. If a patient comes to me with such a situation I usually suggest them to undergo surgery. In surgery I confirm malignancy by frozen section. Here the tissue is studied immediately after removing from body and results will be given in 15 to 20 mins . After that I proceed for total removal of thyroid gland . Next step will be removal of lymphnode after confirming spread to them by frozen section. After histopathology report which takes 4 to 5 days to come I usually decide to give thyriod supplements and radio iodine ablation or not. The results of sugery for thyroid malignancy are good and survival is not affected by this malignancy as it is less aggressive and slow growing and slow spreading malignancy. You can consult a cancer specialist surgeon. Hope I have answered your query . If any further queries are there I would love to help . Regards Dr.Deepika Patil