3cm hypoechoic solid vascular thyroid nodule with a cluster of hurthle cells, fna benign, follow up ultrasound now shows microcalcifications. cancer?

Afirma: You need a repeat biopsy with an afirma assay to screen more critically for possible malignancy. Surgery may be necessary if worrisome changes on ultrasound continue.

Not necessarily...: The fact that FNA was reported as benign, the nodule is unlikely to be malignant. Small droplets of benign colloid often mimic "microcalcificatins" of papillary tumor, hence caution is advised. I would suggest repeating the FNA, and consider also collecting samples for gene profiling studies, such as, those manufactured by Veracyte and Asuragen (Note:I have no financial/other interest.)