Path report help

January 2, 2006

Real close to 2 months since my TT. I'm rereading all my test results

I obtained. I still need to get a copy of the surgical report and 3

blood tests. In my path report it says " background multinodular

hyperplasia with hurthle cell change. " Does anyone know what that

means, the hurthle part ? For the other lobe it just says "

background

multinodular hyperplasia. " I figure that is better news. My next endo

appt is early Feb and I intend to ask all my test result questions

then.

The left lobe says the nodule 3.6x3.2x3.0 cm. It was a big mother! 5

nodules make up that big mother.

At one point the report says " there is no vascular or capsular

invasion

grossly identified. " But then later under the microscopic findings,

it

says " tumor is present in small vessels surrounding the nodule. " When

I was endo doc shopping, one said vascular invasion meant the cancer

had a blood supply. The other one said cancer had gone into the blood

vessels in the thyroid. So is the path report saying both things

here ?

What does " cystic degeneration " mean?

Right thyroid largest nodule 3.5x2.9 cm.

And just now rereading it, the last words are that 2 flattened

parathyroid glands are present adjacent to the nodule. That means I

only have 2 left. First time seeing that, it hasn't been pointed out

to me. Surgeon told me, if I heard right on very little sleep and on

pain meds, that he'd been able to keep the parathyroids in.

Think I'll have endo or his PA go over reports with me line by line,

explaining.

I knew I needed to reread these results and reports, but haven't felt

up to it. I did it a couple days ago and cried as I read. These

things that were done to me and have gone on in me.

And this is enough for tonight. Pace myself out. I'll dig into more

later.

Thanks in advance to those who take time to reply.

jane<---on the laptop with cat making a very good armrest ! ( : I'm

happy, he's happy.

tt 11/7/05

papca encap, vasc inva 12/5/05

rai 139 11/25/05

wbs 12/2/05

levothyroxine 200 12/9/05

January 3, 2006

blood tests. In my path report it says " background multinodular

> hyperplasia with hurthle cell change. " Does anyone know what that

> means, the hurthle part ? For the other lobe it just says "

> background

> multinodular hyperplasia. " I figure that is better news.

Multi means multiple..

Nodular refers to nodules, growths.

Hyper means excessive..more than..

Plasia refers to cell growth..

Hurthle cell change refers to what the cells look like under a

microscope..this refers to changes in the cellular structure usually

associated with cell damage from Hashimoto's..this is the most

common type of thyroid cancer and why they reccomend a suppressed

TSH below 1 with someone with Hashimoto's disease.

(Hurthle cells may or may not be cancerous but represent a non

uniform cellular structure change which is a signal for cancer

depending on the shape of the cells.)

Basically the report means your thyroid was enlarged and contained

more than one nodule and showed changes in the cellular structure

consistant with abnormal cell formation in one side of the thyroid.

The most common and easily treated type of cancer involves Hurthle

cells..

Kats3boys

January 3, 2006

blood tests. In my path report it says " background multinodular

> hyperplasia with hurthle cell change. " Does anyone know what that

> means, the hurthle part ? For the other lobe it just says "

> background

> multinodular hyperplasia. " I figure that is better news.

Multi means multiple..

Nodular refers to nodules, growths.

Hyper means excessive..more than..

Plasia refers to cell growth..

Hurthle cell change refers to what the cells look like under a

microscope..this refers to changes in the cellular structure usually

associated with cell damage from Hashimoto's..this is the most

common type of thyroid cancer and why they reccomend a suppressed

TSH below 1 with someone with Hashimoto's disease.

(Hurthle cells may or may not be cancerous but represent a non

uniform cellular structure change which is a signal for cancer

depending on the shape of the cells.)

Basically the report means your thyroid was enlarged and contained

more than one nodule and showed changes in the cellular structure

consistant with abnormal cell formation in one side of the thyroid.

The most common and easily treated type of cancer involves Hurthle

cells..

Kats3boys

January 3, 2006

blood tests. In my path report it says " background multinodular

> hyperplasia with hurthle cell change. " Does anyone know what that

> means, the hurthle part ? For the other lobe it just says "

> background

> multinodular hyperplasia. " I figure that is better news.

Multi means multiple..

Nodular refers to nodules, growths.

Hyper means excessive..more than..

Plasia refers to cell growth..

Hurthle cell change refers to what the cells look like under a

microscope..this refers to changes in the cellular structure usually

associated with cell damage from Hashimoto's..this is the most

common type of thyroid cancer and why they reccomend a suppressed

TSH below 1 with someone with Hashimoto's disease.

(Hurthle cells may or may not be cancerous but represent a non

uniform cellular structure change which is a signal for cancer

depending on the shape of the cells.)

Basically the report means your thyroid was enlarged and contained

more than one nodule and showed changes in the cellular structure

consistant with abnormal cell formation in one side of the thyroid.

The most common and easily treated type of cancer involves Hurthle

cells..

Kats3boys

January 3, 2006

What does " cystic degeneration " mean?

>

> Right thyroid largest nodule 3.5x2.9 cm.

>

> And just now rereading it, the last words are that 2 flattened

> parathyroid glands are present adjacent to the nodule. That means I

> only have 2 left. First time seeing that, it hasn't been pointed

out

oops..replied before answering these questions..

Cystic degeneration means that the nodules or a nodule were breaking

down..usually a cold nodule will have its cellular structure

die..this is the body's natural way of healing..sort of like when

you have a scap , it falls off after healing and breaks apart..the

body inside is designed the same way except it reabsorbs the

cellular structure after breaking it down.

2 flattened parathyroids does not mean you only have two..it means

just that, 2 of them were compressed by the swelling of the thyroid

to be flat in shape..

Kats3boys

January 3, 2006

What does " cystic degeneration " mean?

>

> Right thyroid largest nodule 3.5x2.9 cm.

>

> And just now rereading it, the last words are that 2 flattened

> parathyroid glands are present adjacent to the nodule. That means I

> only have 2 left. First time seeing that, it hasn't been pointed

out

oops..replied before answering these questions..

Cystic degeneration means that the nodules or a nodule were breaking

down..usually a cold nodule will have its cellular structure

die..this is the body's natural way of healing..sort of like when

you have a scap , it falls off after healing and breaks apart..the

body inside is designed the same way except it reabsorbs the

cellular structure after breaking it down.

2 flattened parathyroids does not mean you only have two..it means

just that, 2 of them were compressed by the swelling of the thyroid

to be flat in shape..

Kats3boys

January 3, 2006

What does " cystic degeneration " mean?

>

> Right thyroid largest nodule 3.5x2.9 cm.

>

> And just now rereading it, the last words are that 2 flattened

> parathyroid glands are present adjacent to the nodule. That means I

> only have 2 left. First time seeing that, it hasn't been pointed

out

oops..replied before answering these questions..

Cystic degeneration means that the nodules or a nodule were breaking

down..usually a cold nodule will have its cellular structure

die..this is the body's natural way of healing..sort of like when

you have a scap , it falls off after healing and breaks apart..the

body inside is designed the same way except it reabsorbs the

cellular structure after breaking it down.

2 flattened parathyroids does not mean you only have two..it means

just that, 2 of them were compressed by the swelling of the thyroid

to be flat in shape..

Kats3boys

January 4, 2006

Thanks Kats. I'm waiting for endo's PA, who handles patient questions, to call, for us to connect. Seems in my reading, I heard Hurthle is one of the worse thyca's. I also read it can mean a precancerous condition. Since I had papca, well, it makes sense. Just want to make sure there's not Hurthle cancer too.

I had 3 docs tell me my thyroid was close to dying, so it makes sense what cystic degeneration means.

About the flattened parathyroids the pathology report says. Since the report came from looking at my removed thyroid, wouldn't it be commenting on what it found in the tissues submitted ? And so, wouldn't saying there are 2 flattened parathyroids mean the parathyroids, flattened, were on the thyroid lobe submitted ? Would the lobe show that the paras had been flattened against them but now paras are still in my neck ?

Just found out today it's normal for me to still be so fatigued. That, and knowing what the path report means, is a great relief. Thanks.

I need to ask for a copy of the surgical report and a couple blood tests. Writing that down now, cuz I will forget with this still hypo brain.

I do lab work on the adrenal growth tomorrow, for me, Wednesday.

jane

tt 11/7/05papca encap; vasc inva 12/5/05rai 139 11/25/05wbs 12/2/05 normal post ttlevothyroxine 200 12/9/05

From: kats3boys

blood tests. In my path report it says " background multinodular> hyperplasia with hurthle cell change." Does anyone know what that> means, the hurthle part ? For the other lobe it just says " > background> multinodular hyperplasia." I figure that is better news.Multi means multiple..Nodular refers to nodules, growths.Hyper means excessive..more than..Plasia refers to cell growth..Hurthle cell change refers to what the cells look like under a microscope..this refers to changes in the cellular structure usually associated with cell damage from Hashimoto's..this is the most common type of thyroid cancer and why they reccomend a suppressed TSH below 1 with someone with Hashimoto's disease.(Hurthle cells may or may not be cancerous but represent a non uniform cellular structure change which is a signal for cancer depending on the shape of the cells.) Basically the report means your thyroid was enlarged and contained more than one nodule and showed changes in the cellular structure consistant with abnormal cell formation in one side of the thyroid.The most common and easily treated type of cancer involves Hurthle cells..Kats3boys

January 4, 2006

Thanks Kats. I'm waiting for endo's PA, who handles patient questions, to call, for us to connect. Seems in my reading, I heard Hurthle is one of the worse thyca's. I also read it can mean a precancerous condition. Since I had papca, well, it makes sense. Just want to make sure there's not Hurthle cancer too.

I had 3 docs tell me my thyroid was close to dying, so it makes sense what cystic degeneration means.

About the flattened parathyroids the pathology report says. Since the report came from looking at my removed thyroid, wouldn't it be commenting on what it found in the tissues submitted ? And so, wouldn't saying there are 2 flattened parathyroids mean the parathyroids, flattened, were on the thyroid lobe submitted ? Would the lobe show that the paras had been flattened against them but now paras are still in my neck ?

Just found out today it's normal for me to still be so fatigued. That, and knowing what the path report means, is a great relief. Thanks.

I need to ask for a copy of the surgical report and a couple blood tests. Writing that down now, cuz I will forget with this still hypo brain.

I do lab work on the adrenal growth tomorrow, for me, Wednesday.

jane

tt 11/7/05papca encap; vasc inva 12/5/05rai 139 11/25/05wbs 12/2/05 normal post ttlevothyroxine 200 12/9/05

From: kats3boys

blood tests. In my path report it says " background multinodular> hyperplasia with hurthle cell change." Does anyone know what that> means, the hurthle part ? For the other lobe it just says " > background> multinodular hyperplasia." I figure that is better news.Multi means multiple..Nodular refers to nodules, growths.Hyper means excessive..more than..Plasia refers to cell growth..Hurthle cell change refers to what the cells look like under a microscope..this refers to changes in the cellular structure usually associated with cell damage from Hashimoto's..this is the most common type of thyroid cancer and why they reccomend a suppressed TSH below 1 with someone with Hashimoto's disease.(Hurthle cells may or may not be cancerous but represent a non uniform cellular structure change which is a signal for cancer depending on the shape of the cells.) Basically the report means your thyroid was enlarged and contained more than one nodule and showed changes in the cellular structure consistant with abnormal cell formation in one side of the thyroid.The most common and easily treated type of cancer involves Hurthle cells..Kats3boys

January 4, 2006

Your comments read funny... or it's just me.... sounds like you are saying Hashi's is thyroid cancer.. it's not... it's an autoimmune disorder, gland tissue damaged by antibody attack... the hurtle cells are independent of that and are the cancer part, right?

I just got all confused... it's too early? I need to eat breakfast so my brain wakes up and I can read right? hehehehee

Topper ()"Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body. But rather to skid in sideways, chocolate in hand, body thoroughly used up, totally worn out and screaming "WOO-HOO what a ride!"

On Wed, 04 Jan 2006 06:55:10 -0000 "kats3boys" writes:

blood tests. In my path report it says " background multinodular> hyperplasia with hurthle cell change." Does anyone know what that> means, the hurthle part ? For the other lobe it just says " > background> multinodular hyperplasia." I figure that is better news.Multi means multiple..Nodular refers to nodules, growths.Hyper means excessive..more than..Plasia refers to cell growth..Hurthle cell change refers to what the cells look like under a microscope..this refers to changes in the cellular structure usually associated with cell damage from Hashimoto's..this is the most common type of thyroid cancer and why they reccomend a suppressed TSH below 1 with someone with Hashimoto's disease.(Hurthle cells may or may not be cancerous but represent a non uniform cellular structure change which is a signal for cancer depending on the shape of the cells.) Basically the report means your thyroid was enlarged and contained more than one nodule and showed changes in the cellular structure consistant with abnormal cell formation in one side of the thyroid.The most common and easily treated type of cancer involves Hurthle cells..Kats3boys

January 4, 2006

Your comments read funny... or it's just me.... sounds like you are saying Hashi's is thyroid cancer.. it's not... it's an autoimmune disorder, gland tissue damaged by antibody attack... the hurtle cells are independent of that and are the cancer part, right?

I just got all confused... it's too early? I need to eat breakfast so my brain wakes up and I can read right? hehehehee

Topper ()"Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body. But rather to skid in sideways, chocolate in hand, body thoroughly used up, totally worn out and screaming "WOO-HOO what a ride!"

On Wed, 04 Jan 2006 06:55:10 -0000 "kats3boys" writes:

blood tests. In my path report it says " background multinodular> hyperplasia with hurthle cell change." Does anyone know what that> means, the hurthle part ? For the other lobe it just says " > background> multinodular hyperplasia." I figure that is better news.Multi means multiple..Nodular refers to nodules, growths.Hyper means excessive..more than..Plasia refers to cell growth..Hurthle cell change refers to what the cells look like under a microscope..this refers to changes in the cellular structure usually associated with cell damage from Hashimoto's..this is the most common type of thyroid cancer and why they reccomend a suppressed TSH below 1 with someone with Hashimoto's disease.(Hurthle cells may or may not be cancerous but represent a non uniform cellular structure change which is a signal for cancer depending on the shape of the cells.) Basically the report means your thyroid was enlarged and contained more than one nodule and showed changes in the cellular structure consistant with abnormal cell formation in one side of the thyroid.The most common and easily treated type of cancer involves Hurthle cells..Kats3boys

January 4, 2006

Your comments read funny... or it's just me.... sounds like you are saying Hashi's is thyroid cancer.. it's not... it's an autoimmune disorder, gland tissue damaged by antibody attack... the hurtle cells are independent of that and are the cancer part, right?

I just got all confused... it's too early? I need to eat breakfast so my brain wakes up and I can read right? hehehehee

Topper ()"Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body. But rather to skid in sideways, chocolate in hand, body thoroughly used up, totally worn out and screaming "WOO-HOO what a ride!"

On Wed, 04 Jan 2006 06:55:10 -0000 "kats3boys" writes:

blood tests. In my path report it says " background multinodular> hyperplasia with hurthle cell change." Does anyone know what that> means, the hurthle part ? For the other lobe it just says " > background> multinodular hyperplasia." I figure that is better news.Multi means multiple..Nodular refers to nodules, growths.Hyper means excessive..more than..Plasia refers to cell growth..Hurthle cell change refers to what the cells look like under a microscope..this refers to changes in the cellular structure usually associated with cell damage from Hashimoto's..this is the most common type of thyroid cancer and why they reccomend a suppressed TSH below 1 with someone with Hashimoto's disease.(Hurthle cells may or may not be cancerous but represent a non uniform cellular structure change which is a signal for cancer depending on the shape of the cells.) Basically the report means your thyroid was enlarged and contained more than one nodule and showed changes in the cellular structure consistant with abnormal cell formation in one side of the thyroid.The most common and easily treated type of cancer involves Hurthle cells..Kats3boys

January 5, 2006

>

> Your comments read funny... or it's just me.... sounds like you are

> saying Hashi's is thyroid cancer.. it's not... it's an autoimmune

> disorder, gland tissue damaged by antibody attack... the hurtle

cells are

> independent of that and are the cancer part, right?

>

> I just got all confused... it's too early? I need to eat breakfast

so my

> brain wakes up and I can read right? hehehehee

>

> Topper ()

Hope this explains things..and the connection..

hashi's does not cause cancer..but it does destroy the thyroid and

this cellular damage can leave more room for something to go

wrong..sort of like how many times you get sunburnt increases your

risk for skin cancer.

From Merck..

PAPILLARY CARCINOMA

Papillary carcinoma is the most common thyroid cancer (60 to 70% of

all thyroid cancers). Females are affected two to three times more

often than males. It is more frequent in the young, but is more

malignant in the elderly. It is more common in patients with a

history of radiation exposure and spreads via the lymphatic system.

Lateral aberrant thyroid rests may be found that are actually occult

metastases with a benign histologic appearance. These well-

differentiated cancers may be TSH-dependent and may develop in

goiters secondary to Hashimoto's thyroiditis. Many papillary

carcinomas contain follicular elements, but this does not alter the

basic biology of the tumor.

Treatment

Treatment for small (< 1.5 cm) encapsulated tumors localized to one

lobe is usually lobectomy and isthmectomy, although some experts

recommend more extensive thyroid surgical treatment. Thyroid hormone

in TSH suppressive doses is given to minimize chances of regrowth or

to regress any microscopic remnants of papillary carcinoma; surgical

treatment is almost always curative. Large (> 1.5 cm) or diffusely

spreading tumors often require total or near-total thyroidectomy

with postoperative radioiodine scans and subsequent ablation of

residual thyroid tissue with appropriately large doses of 131I

administered when the patient is hypothyroid. Alternatively,

recombinant TSH can be administered for 2 days prior to 131I for

the diagnostic scan to detect residual thyroid tissue or cancer,

thus avoiding the need to let the patient become hypothyroid prior

to the diagnostic scan. Repeat treatment may be required every 6 to

12 mo to achieve ablation of the remaining thyroid tissue. TSH

suppressive doses of L-thyroxine are given after treatment, and

measurement of serum thyroglobulin is useful in detecting recurrent

or persistent disease.

From the Thyroid manager

Pathology ( Hashimoto's)

The goiter is generally symmetrical, often with a conspicuous

pyramidal lobe. Grossly, the tissue involved by Hashimoto's

thyroiditis is pinkish-tan to frankly yellowish and tends to have a

rubbery firmness. The capsular surface is gently lobulated and non-

adherent to peri-thyroid structures. Microscopically, there is a

diffuse process consisting of a combination of epithelial cell

destruction, lymphoid cellular infiltration, and fibrosis. The

thyroid cells tend to be slightly larger and assume an acidophilic

staining character; they are then called Hurthle or Askanazy cells

and are packed with mitochondria. The follicular spaces shrink, and

colloid is absent or sparse. Fibrosis may be completely absent or

present in degrees ranging from slight to moderate; it may be

severe, as observed in subacute or Riedel's thyroiditis. Foreign

body giant cells and granulomas are not features of Hashimoto's

thyroiditis, in contrast to subacute thyroiditis. In children,

oxyphilia and fibrosis are less prominent, and hyperplasia of

epithelial cells may be marked. Deposits of dense material

representing IgG are found along the basement membrane on electron

microscopy .

FNA can be a useful diagnostic procedure but is infrequently

required, except in patients that seem to have- or have- a discreet

nodule in the gland. FNA typically reveals lymphocytes, macrophages,

scant colloid, and a few epithelial cells which may show Hurthle

cell change. In this context Hurthle cells do not represent a

discrete adenoma. However if only abundant Hurthle cells dominate

the specimen, and there are few or no lymphocytes or macrophages,

the biopsy must be interpreted as a possible Hurthle cell tumor.

Biopsy results are less frequently diagnostic in children(95).

Hope this helps with what I was trying to say.

Kats3boys.

January 5, 2006