Found thyroid nodule, is CNB the correct method to determine if benign or malignant?
I am a 33 y/o Caucasian female with no family medical history of thyroid issues or thyroid cancer (family medical history: my father has diabetes and bipolar disorder, my sister and I myself have bipolar disorder, and there are no other significant medical issues in the family). In May 2016, my GP suggested I get an ultrasound for a thyroid nodule on the right side of my thyroid that she discovered during a routine physical exam. I had the US in June. According to the US report, “The right thyroid lobe measures 5.1 x 2.1 x1.9 cm. The left thyroid lobe measures 3.3 x 1.1 x 1.6 cm. There is a 4 mm nodule in the right mid gland. There is a 2 cm nodule in the lower pole of the right thyroid lobe. Impression: A 2cm nodule in the lower pole of the right thyroid lobe. Ultrasound guided fine needle aspiration suggests an established diagnosis.”
I then had a fine-needle aspiration biopsy (FNA) in July. The results came back “atypical” (I don’t have them on hand right now, but I can send them to you). I then consulted with a thyroid specialist, who recommended a partial lobectomy to establish a diagnosis. I have been doing some research into the medical literature (via PubMed, etc) and it sounds like perhaps a core-needle biopsy (CNB) may provide a more definitive diagnosis and help me determine if I should go the surgical route or not (if the nodule turns out to be cancerous or precancerous, I will of course go with surgery, but since it’s atypical and it could turn out to be malignant or benign, I would like to exhaust any other options available in determining the diagnosis before electing to have surgery). I also had blood work done in May. TSH and (TPO) Ab and T4, Free (Direct) were in normal ranges (TSH was 1.420 and (TPO) Ab was 9 IU/mL and T4 was 1.36) and TgAb was a little high (2.1 IU/mL). Everything else (CBC w/diff, CMP, lipid panel) came back normal. Can you help, please? Happy to send you the US and FNA results. My question is: Would you recommend CNB or some other method to determine if the nodule is benign or malignant besides surgery? I just want to exhaust all my options if I can.