Presentation
Nodular thyroid gland.
Patient Data
Right thyroid isoechoic nodule. Several passes with a 25G FNA needle.
Case Discussion
FNA Histology
FNA right thyroid:
The specimen is highly cellular containing groups of follicular cells arranged in predominantly, repetitive micro-follicles. Some follicular cells are found in crowded clusters with overlapping and mildly enlarged nuclei, nuclear pleomorphism and focal grooves. The background consists of blood and scant thick colloid.
SUMMARY
FNA right thyroid: Suggestive of a follicular neoplasm (Category 4).
Right thyroidectomy histology
Right hemithyroidectomy - stitch upper pole: The right hemithyroidectomy specimen shows a large nodule with well-circumscribed fibrosis around it. The features are that of an adenoma. There is no evidence of capsular or vascular invasion. The sections also reveal the presence of two foci of micropapillary carcinoma, measuring 6 mm and 5 mm in maximum dimension in sections 1E and 1J. There appear to be two benign parathyroid glands identified. There is also a separate larger hyperplastic nodule in section 1L.
SUMMARY
Right thyroidectomy: micropapillary carcinoma