We are at the beach for an extra long weekend getaway, which means I am writing this on my phone. I have been trying really hard to stay research-free, with mixed success. The past few days have been good, and I have made a personal vow to myself not to look up anything related to my thyroid issues at least while we are on vacation.
That said, I did go on a PubMed binge several days ago (before vacation), and I learned a few more things that I wanted to make note of here.
One is that “hemosiderin laden macrophages” can occur in HCC. (ETA: Here’s the article.). So, in terms of my Hurthle cell lesion, it doesn’t, as I previously believed, matter if my macrophages have hemosiderin or not.
Also, I had previously read an abstract that listed “absence of inflammation” as an increased risk factor for malignancy in Hurthle cell lesions. I thought this was a food sign for me, since I know my thyroid has inflammatory cells (lymphocytes) in it. But I found the full text of the article, and what “absence of inflammation” meant in their study was an absence of inflammatory cells within the lesion. Well, as far as my FNA report goes, there aren’t any inflammatory cells in my Hurthle cell lesion, so that is no longer a factor in my favor.
I feel like these two findings tip the needle a little away from the benign side, but not necessarily more towards the malignant side, if that is even possible or makes sense. I’m not sure it does.
The fact is that I feel mostly like I will have the surgery, get a benign diagnosis (maybe including Hashimoto’s and/or multi-modular goiter) and go on my merry way. I know that things may go a different direction, and I am trying to be prepared for that possibility without dwelling on it or inviting it into my life.
Weaning is still not going great. We are going to try to use the change of routine during this vacation to eliminate nap-time nursing. Then we’ll be down to just first thing in the morning.