Presentation
Referred for a thyroid US +/- FNA.
Patient Data
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 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. Tumor cells demonstrate nuclear enlargement with crowding and overlapping, intranuclear grooves and chromatin clearing. The ill-defined unencapsulated tumor 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 tumor extension: present. - inked resections margins: tumor involves posterior margin.
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