Monday, August 23, 2010


My doc’s office faxed the cytology report to me this morning, but rather than illumination, I have received confusion.

Literally all the report says is:
Right thyroid nodule (fine needle aspiration)
--Hypercellular aspirate fluid composed of blood with scant colloid and cytologically atypical follicle cells
--Excision of this lesion is recommended

Note: Four smears are reviewed

It is my understanding (from the famous literature) that the “hypercellular aspirate [. . .] with scant colloid” is typical of follicular neoplasms, while “cytologically atypical follicle cells” is of no help whatsoever. “Atypical” how exactly? Okay so “not normal” but there are oh-so-many ways for a cell to be “not normal.” And are there scant cytologically atypical follicle cells, or is it scant colloid. . .AND THEN ALSO cytologically atypical follicle cells? If there are lots of cells (hypercellularity) but scant cytologically atypical follicle cells, then shouldn’t this be re-biopsied rather than sent straight in for surgery?

Well, but this paper suggests that my risk of cancer is now hovering around 25%, so not as bad as I thought, but still worse than a 1% chance.


  1. There should be some sort of note how these cells are arranged (in what pattern) micro-follicular or macrofollicular. The nodule with micro-follicular pattern AND scant colloid is classical neoplasm, while anythyng else warrants the second opinion.

  2. Thanks for all the info and encouragement, doctor j!

    Unfortunately, there is nothing on my pathology report indicating how the cells are arranged. All the report says is what I posted--literally. There are three lines of text, minus all the official gobbeldy-gook (signature, address, etc.). I was very disappointed because I thought I was going to get a lot more information than that.

    My US report was the same: nothing about echogenicity, vascularization, calcifications, etc. The report only says it's a 2.5 cm solid nodule. So, it really only confirms what I can feel myself, with the added "bonus" of confirming it's not a cyst (which is what I was hoping it was).

    I see people posting their reams of info on-line, and I think, "where are they going for their medical care? I'm lucky to get one complete sentence."

    Anyway, thanks again!

  3. Not sure if you read this article it provide good information what steps are necessary for proper evaluation of the nodule.
    You may ask for the disc (CD) with your ultrasound and have it evaluated by different person (preferably a doctor not technician)