Riedel`s disease
Riedel`s disease This rare disease is characterized by a dense fibrosis which replaces the parenchyma of the thyroid and extends to the surrounding structures, resulting in a hard mass in the neck which clinically mimics a carcinoma. The aspiration usually results in a dry tap because of the dense fibrosis.
Parathyroid tumours
Parathyroid adenomas and the rare parathyroid carcinoma can be clinically mistaken for thyroid nodules. Smears are cellular, with cohesive sheets, ribbon-like cords and occasional microacini. The cells have round nuclei with a coarsely granular chromatin pattern and granular cytoplasm. Bare nuclei and isolated cells can be present. Slight and focal nuclear pleomorphism can be seen. […]
Evaluation of the specimen
Several features will be considered in the evaluation of the specimen: the type of cells (such as thyrocytes, macrophages, lymphocytes) Thyrocytes and macrophages. Fluid colloid in the background, bland thyrocytes and pigmented macrophages. Lymphocytes and thyrocytes. A group of bland thyroid cells showing a follicular arrangement, surrounded by smaller lymphoid cells with little amount of identifiable cytoplasm. […]
Multinodular goitre
It is a nodular enlargement of the gland, due to derangements in hormone production, which is often asymmetric and sometimes extreme. Follicular cells undergo hyperplasia, leading to the formation of several nodules. The nodules, which are usually not encapsulated, may considerably vary in their microscopic appearance: some of them are composed of very large macrofollicles […]
Papillary carcinoma
Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid (>80% of thyroid cancers). It may occur at any age, but most patients are between 30 and 50 years old; most of them are female (F:M 3:1). It usually presents as a solitary, non-functioning (‘cold’) nodule, sometimes with cervical lymphadenopathy due to metastatization. […]
Terminology for reporting results
Terminology for reporting results It is advisable to use diagnostic categories such as negative (benign), suspicious, positive (malignant) and non-diagnostic (unsatisfactory), followed by a description. Negative (benign) aspirate Positive (malignant) aspirate Suspicious aspirate An increasingly used classification identifies five categories basically splitting the suspicious category into probably reactive (T3 – low risk of malignancy) and […]
Radiation changes
Long-term morphologic changes may occur in the thyroid of patients who undergo external irradiation of the neck (usually as a therapy of malignancies) or administration of radioactive iodine (which is used to treat hyperthyroidism). Cytologic diagnostic features sheets (macrofollicles) enlarged cells normal N/C ratio Hürthle cell change cytoplasmic vacuolization marked nuclear atypia: marked size variation […]
Negative (benign) aspirate
This category accounts for the vast majority of FNA aspirates, proportions from different series ranging from 50-75%. Between 60-85% of negative aspirates are obtained from either dominant nodules within nodular hyperplasia or dominant nodules of non-toxic goitre. The remainder of negative specimens are obtained from other benign lesions, such as cysts, inflammatory lesions (e.g. thyroiditis), […]
The follicular lesions
The follicular lesions The follicular lesions include follicular adenoma and follicular carcinoma. Papillary carcinoma also derives from follicular cells, but it is distinguished from the other lesions by its characteristic nuclear features. While for some conditions, such as Hashimoto`s thyroiditis and papillary carcinoma, FNA can be diagnostic, for the follicular lesions it represents a screening […]
Positive (malignant) aspirate
Positive (malignant) aspirate Thyroid cancer (although the most common endocrine malignancy) is rare, accounting for less than 1% of solid tumours. Annual UK incidence of thyroid malignancy is approximately 2.3 per 100,000 women and 0.9 per 100,000 men. Primary thyroid malignancies can be divided into differentiated (papillary and follicular carcinoma), medullary and anaplastic carcinomas, being […]