Papillary thyroid carcinoma

Case contributed by Dr Bruno Di Muzio

Presentation

Referred for a thyroid US +/- FNA.

Patient Data

Age: 40
Gender: Female
Ultrasound

Thyroid ultrasound

Within the mid to the lower third of the left thyroid lobe there is a circumscribed solid nodule measuring up to 1.5 cm, hypoechoic, with some microcalcifications and internal vascularity. No neck lymphadenopathy identified. 

CT

CT Neck

Ce of the Neck has not shown any suspicious lymphadenopathy or other neck abnormalities besides the previously identified thyroid nodule.  

Case Discussion

FNA and further left hemithyroidectomy were performed.

MICROSCOPIC DESCRIPTION: Sections of thyroid gland show a 9mm papillary thyroid carcinoma composed of slit-like follicles and papillary structures. Scattered psammomatous microcalcifications are present. Tumour cells demonstrate nuclear enlargement with crowding and overlapping, intranuclear grooves and chromatin clearing. The ill-defined unencapsulated tumour infiltrates into adjacent fibroadipose tissue and extends to involve the inked posterior margin. No lymphovascular or perineural invasion is seen. The adjacent thyroid parenchyma appears unremarkable.

DIAGNOSIS: Thyroid gland, left hemithyroidectomy: Papillary thyroid carcinoma: - size: 9mm maximum dimension (microcarcinoma). - lymphovascular invasion: absent. - perineural invasion: absent. - extra-thyroidal tumour extension: present. - inked resections margins: tumour involves posterior margin.

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Case information

rID: 55437
Case created: 6th Sep 2017
Last edited: 1st Nov 2017
System: Head & Neck
Inclusion in quiz mode: Included

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