5 doctors weighed in:

I was wondering if thyroidectomy the only way to determine if a papillary lesion / follicular neoplasm is benign or malignant?

5 doctors weighed in
Dr. Barry Rosen
Surgery
3 doctors agree

In brief: No/Yes

Papillary cancers can usually be diagnosed by fine needle aspiration biopsy (fnab) preoperatively.
In contrast, the distinction between a benign and malignant follicular neoplasm can only be determined by removing the thyroid lobe that contains the nodule. In these situations, the pathologist is looking for cellular invasion into blood vessels or the capsule of thyroid: this cannot be seen by fnab.

In brief: No/Yes

Papillary cancers can usually be diagnosed by fine needle aspiration biopsy (fnab) preoperatively.
In contrast, the distinction between a benign and malignant follicular neoplasm can only be determined by removing the thyroid lobe that contains the nodule. In these situations, the pathologist is looking for cellular invasion into blood vessels or the capsule of thyroid: this cannot be seen by fnab.
Dr. Barry Rosen
Dr. Barry Rosen
Thank
Dr. David Rosen
Internal Medicine - Oncology
1 doctor agrees

In brief: Thyroid FNA

There are several different results for fna biopsy.
Benign 5%risk of cancer, follicular lesion of undetermined significance (flus)10% risk of cancer, follicular neoplasm 30% risk of cancer, suspicious for papillary cancer 70% risk of cancer, papillary cancer > 90% risk of cancer, generally a diagnosis of follicular neoplasm requires lobectomy. Flus should be repeated in 3 m with veracyte test.

In brief: Thyroid FNA

There are several different results for fna biopsy.
Benign 5%risk of cancer, follicular lesion of undetermined significance (flus)10% risk of cancer, follicular neoplasm 30% risk of cancer, suspicious for papillary cancer 70% risk of cancer, papillary cancer > 90% risk of cancer, generally a diagnosis of follicular neoplasm requires lobectomy. Flus should be repeated in 3 m with veracyte test.
Dr. David Rosen
Dr. David Rosen
Thank
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