Am I making a mistake?
(31, F) I’m leaning towards surveillance instead of jumping to a diagnostic lobectomy after an AUS Bethesda III and Afirma 50% suspicious result, no mutations.
Ultrasound shows my TIRADS 3, 2.8cm nodule, to be about 60-70% cystic with a dependent portion of solid, which surgeon believes to be settled clotting or debris. Cola-colored fluid was aspirated during FNA. Clear lymph nodes.
TSH 1.61
Cytopathology comments: These features are best classified as atypia of undetermined significance, focal, favor reactive lining cells.
Microscopic Description: The cytologic and cell block preparations are sparsely cellular and show rare clusters of epithelioid histiocytoid cells with focal
nuclear enlargement and oncocytic cytoplasm in a background of macrophages.
I’m 3 months postpartum and read that pregnancy/postpartum can temporarily alter RNA expression in the thyroid, making molecular testing accuracy difficult. Aside from being 50% suspicious, which would make sense if pp really does affect RNA, I feel as though there are enough reassuring facts to make me lean towards holding onto my thyroid a bit longer (especially while recovering pp) in hopes that I can possibly see a more clear picture on a future re-biopsy to make a more informed decision.
I also had a 1cm solid nodule that did not qualify for FNA and ended up disappearing between my first US in March and consult with surgeon this week.
While I discovered this nodule myself just a couple months ago at 1 month pp, I was looking back at pictures and noticed that it might’ve been with me since 2024.
Thank you for reading. This has been a very confusing road so far…