Clinical presentation: a 53-year old woman was referred for an evaluation of a suspected hypothyroidism. She gained 15 kg in weight. She noticed a lump in the right thyroid a year earlier which caused no complaints.

Palpation: a very firm nodule in the left lobe.

Hormonal examination indicated euthyroidism with TSH 3.14 mIU/L.

Ultrasonography a solitary hypoechogenic nodule with a halo sign and perinodular blood flow in the right thyroid.

FNAC report: follicular tumor with greater than average risk of malignancy.

Histopathology: disclosed minimally invasive follicular cancer.

Comment: it is worth comparing of the first five cytological images with the last five pictures. The pattern of the former suggests a typical follicular proliferation while the latter does an atypical follicular tumor. The images come from different parts of the same smear.

 

 

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