Hello there,
I am new to this forum and am looking for some additional advice and perspectives (I plan to seek a second opinion though with a specialist).
I'm a 43 year old female.
I have more than one thyroid nodule, one of which was rated on ultrasound as TIRADS 4 with moderately suspicious features including hypoechoic, hyper/central vascularity and micro-calcifications.
An FNA biopsy came back as AUS (Bethesda 3) with less pronounced cellularity, showing thyrocytes and also Hurthle cells, single and in smaller clusters, with nuclei slightly enlarged and "moldy to each other" (nuclear molding?), but with regular contours. Vesicular chromatin. Cytoplasm moderately abundant and basophilic. The smear also contains rare macrophages, colloid and degeneratively changed cells.
I do not have Hashimotos or autoimmune thyroid (ruled out from previous blood work).
I also have a slightly high Thyroglobulin (89.26 ng/mL) and my grandmother had thyroid cancer (not sure which kind). I also have high TSH with normal T3/T4.
The largest nodule which was biopsied above is 48x19x19 mm. They are saying that given the imaging is moderately suspicious and now biopsy shows atypia, that I should have a total thyroedctomy (also for definitive diagnosis).
I want to understand if this is the best course of action?
Also, does this raise the likelihood of malignancy?
They say repeat FNA not advised and molecular testing is not available where I am (I am outside the US).
Thanks for your feedback in advance.
Best,
MJ
