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The borders of the nodule - case conp 037

Nodular goiter

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Clinical presentation: A 33-year-old woman was referred for an evaluation of a nodule discovered by herself several weeks earlier.

Palpation: a hard nodule in the left lobe.

Functional state: euthyroidism (TSH-level 4.60 mIU/L).

Ultrasonography. The thyroid was echonormal. There was a hypoechogenic nodule in the ventral part of the left lobe. The borders of the nodule were irregular, spiculated, the lesion contained microcalcifications and displayed an irregularly increased intranodular vascular pattern.

Cytological diagnosis: Papillary cancer. Lymphocytic thyroiditis.

Histopathology. Papillary cancer with focal lymphocytic thyroiditis. Metastases to the submandibular lymph nodes.

Comments.

  1. The sonographic pattern is highly suspicious for papillary cancer because of the presence of multiple suspicious sonographic characteristics, i.e. hypoechogenicity, irregular borders, microcalcifications, an irregular intranodular vascular pattern.

  2. It is worth analyzing the cytological images - two cell populations were found. Firstly, normal thyroid follicular cells, secondly follicular cells displaying the features of papillary cancer.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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