PracticalPathologyof Thyroid

Case 1A 50 yr old lady presents

with a mass in anterior neck

Slowly growing since 10 yr ago

Soft and nodular, moves with swallowing

No cervical LAD feltRest of PE is normal

Work - up

Thyroid hormone profile ordered :

TSH : 3.5 IU/L (0.5 – 5 IU/L)

T4 : 6.2 µg/dl (4.5 – 12 µg/dL)T3 : 134 ng/ dl (100 – 220 ng/dL)

T3RU : 24 % (20 - 35 %)

Thyroid scan ordered

Work-upThyroid scan ordered

Thyroid scan

Thyroid FNA performed :

Thyroid FNA

Diagnosis: Multinodular goiterPatient underwent surgery :

Microscopic images

Final diagnosis :

Multinodular

Goiter

Case 2A 45 yr old lady presents with a lump in

anterior part of neck at right thyroid lobeSlowly growing since 4 months ago The mass is firm and indiscrete, and moves

with swallowingOther PEs are normalNo cervical LAD is present She has Hx of Raynaud’s phenomenon

Thyroid hormone profile ordered :

TSH: 7.2 IU/L (0.5 – 5 IU/L)

T4: 4.1 µg/dl (4.5 – 12 µg/dL)

T3: 105 ng/dl (100 – 220 ng/dL)

Thyroid FNA performed :

Microscopic features

Final diagnosis: Hashimoto’s

Thyroiditis

Case 3A 33 yr old man presents with

firmness of his left thyroid lobe and a nodule in left cervical chain growing since 2 wks ago

The latter nodule is softThe left thyroid is firmOther exams are normal

Next work-up step : Thyroid FNA

Diagnosis :Papillary carcinoma of thyroid with cervical lymph node metastasis

Patient underwent total thyroidectomy and left cervical LN resection

Gross and microscopic features

microscopic features

Papillae, psamomma bodies

Final dagnosis: Papillary Carcinoma

of Thyroid