Ok, so I couldn’t leave well enough alone. I HAD to keep on researching.
Let me back up. Here is the word-for-word write up of FNA of the the larger nodule on the isthmus of my thyroid:
Hurthle cell lesion–see comment
COMMENT:
The specimen consists of numerous Hurthle cells and fragments of Hurthle cell epithelium, with a population of macrophages. The differential diagnosis includes Hurthle cell change in a background of thyroiditis or a hyperplastic colloid nodule versus a Hurthle cell neoplasm. Clinical correlation recommended and follow up as indicated.
So that actually didn’t sound too bad, especially the idea that it could be “Hurthle cell change in a background of thyroiditis.”
But I couldn’t leave well enough alone. I wanted to know what, if any, meaning the macrophages had. I had some vague memory that macrophages were immune cells, maybe a type of white blood cell? I knew that certain cell types like lymphocytes tended to point towards a benign nodule. So I went looking, using “macrophage” as a term in combination with “Hurthle cell lesion,” “Hurthle cell adenoma,” “Hurthle cell FNA,” etc. ad nauseum.
I found one case study in which two different patients had similar FNA samples that included Hurthle Cells and macrophages. One ended up being a Hurthle Cell Adenoma (benign) and the other a Hurthle Cell Carcinoma (malignant). So I know that macrophages could be present in either.
Then, for whatever reason, I searched for “macrophage thyroid cancer.” From that I learned that macrophages are generally present in tumors (benign or malignant) and that a certain type of macrophage, known as a Tumor-Associated-Macrophages can sometimes make up up to 50% of a tumor, and that their actions tends to help the tumor grow and spread.
I found this article. The title alone almost sent me into a panic attack.
I had a little freak out moment, feeling SURE that the “population of macrophages” meant my nodule is FOR SURE cancer. I have reeled it in a bit, and I’m now back to the recognition that “tumor-associated” doesn’t have to mean “cancer-associated,” and that, once again, I cannot find out if my nodule is cancer or not by doing research. Still, I am not comforted.
I’ve also learned that “hemosiderin-laden” macrophages are usually associated with benign tumors; they “digest” red blood cells when a colloid nodule (always or almost always benign, from what I understand) undergoes “hemorrhagic decay”. My FNA report didn’t say whether the macrophages were “hemosiderin-laden” or not. So I really have no idea where I stand.
Before I made my macrophage discovery, I sent Dr. B an email to ask how long surgery should take (45 minutes to an hour) and where pathology would be done (right here in our local hospital). I have now looked up the pathologists on staff and am considering sending them gift baskets the day before my surgery, to make sure they do top-notch work for me.
Also, my sweet, sweet Aunt Sharon has said that if I need her, she can come for a few days. We are going to play it by ear to see how things go. And UK is in Uganda, preaching. Love it.
Ok, I REALLY, REALLY need to forget all about this until maybe a few days before June 7th! Although, I think it would be good to work on some things that would be helpful to accomplish before surgery. I am going to put my “folder” (containing my lab reports, surgery instructions, etc.) somewhere out-of-the-way.
Should I Google “Hashimoto’s macrophage,” just to make myself feel better? You see how sick I am?
ETA: I did Google some more. I am back to the realization–full realization, not just what I’m telling myself to think–that macrophages don’t mean I have cancer, and very well could point to a Hurthle Cell Lesion associated with Hashimoto’s. Must. Stop. Googling.
