Thyroid Cytopathology

Unknown Cases For Discussion

Syed Z. Ali, M.D. The Johns Hopkins Hospital, Baltimore,

Maryland

Case 1

A 46 year-old woman with a 3.2 cm solid, left thyroid nodule present for 2 years. There has been a recent increase in the size of the nodule. Family history is positive for papillary thyroid carcinoma in the mother, who is alive and free of disease.Ultrasound-guided FNA. Smears stained with Diff-Quik stain.

Case 2

A 55 year-old man with a 3.0 cm solid, right thyroid nodule present for less than 3 months. The nodule shows coarse calcifications, which radiographically,are thought to be suspicious for papillary thyroid carcinoma. Ultrasound-guided FNA. A flow cytometry was ordered after on-site evaluation.Smears stained with Diff-Quik and Papanicolaou stains.

Case 3

A 62 year-old woman presents with a 1.2 cm left lobe thyroid nodule. Past medical history reveals a cavernous sinus meningioma 17 years ago treated with subtotal resection and external beam radiation therapy. The thyroid nodule was discovered incidentally on routine imaging studies. The nodule was noted to have a hypoechoic rim and small, punctate, echogenic foci that were suggestive of microcalcifications. Ultrasound-guided FNA. Smears stained with Diff-Quik and Papanicolaou stains.

Case 4

A 28 year-old woman with an incidentally discovered 1.8 cm solid, left thyroid nodule. She complains of bone pain, worsening fatigue and lethargy. Ultrasound-guided FNA. Smears stained with Diff-Quik and Papanicolaou stains.

Case 5

A 61 yr-old man was evaluated for a slow-growing left thyroid mass that was present for 2 yr despite thyroid hormone suppression. Thyroid-stimulating hormone (TSH) was within normal limits. Past history was significant for radium treatment of his adenoid at age 6.Ultrasound-guided FNA. Smears stained with Diff-Quik and Papanicolaou stains.