Clinical data: a 32-year-old woman was evaluated because of her weight gain. Thyroid nodules were detected on an ultrasound examination. She was sent to aspiration cytology.

Palpation: no abnormality.

Functional state: euthyroidism (TSH-level 1.17 mIU/L).

Ultrasonography: the right thyroid was intact. There were two small hypoechogenic lesions in the left lobe. They displayed microcalcifications.

Cytology: we gained thick, white jelly-like fluid. There was no one intact cell on the smears. Arborizing papillary clusters were found which contained a few necrotic cells.
On a second attempt of FNAC we gained only blood.

Cytological diagnosis: suspicion of papillary carcinoma.

Histopathology: papillary cancer.

Comment: the cytological images and the case history would be very edifying for a cytopathologist. Gaining only necrotic papillary fragments - this is an extremely rare situation. We had no other cases among more than 43.000 thyroid cytologies.