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Extrathyroidal spread - case 2050

Nodular goiter

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Clinical presentation: A 71-year-old woman was referred for a repeat aspiration cytology of a nodule detected by screening. The first cytology performed in another institute resulted in Bethesda III, AUS category.

Palpation: no abnormality.

Laboratory test: TSH 0.86 mIU/L.

Ultrasonography. The thyroid was partly echonormal, partly minimally hypoechoic. There were several more hypoechogenic lesions in both lobes. The largest one in the right lobe had irregular margins and presented clusters of microcalcifications.

Cytology resulted in suspicion of papillary carcinoma.

Right lobectomy was performed, intranodular frozen section resulted in benign lesion. On final histopathology benign hyperplastic nodules were described.

Comment.

  1. Regarding the nodule borders the lesion presented partly lobulated, partly spiculated margins.
  2. The nodule' contour was abutting and the adjacent capsule was discontinuous. On the other hand, this case illustrates the weakness of the latter sign: the capsule was also discontinuous where it did not come into contact with the lesion.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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