Cytologically Yours: Unknowns: 201311: Case 1: Difference between revisions

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==Resident Questions==
===Resident Questions===
* <spoiler text="Diagnosis?">
* <spoiler text="Diagnosis?">Lymphocytic thyroiditis (Hashimoto thyroiditis). </spoiler>
* Lymphocytic thyroiditis (Hashimoto thyroiditis). </spoiler>
* <spoiler text="What are the clinical findings that support this diagnosis?">
* <spoiler text="What are the clinical findings that support this diagnosis?">
* The diagnosis of Hashimoto is based on one or more circulating autoantibodies. The most common are anti-thyroglobulin and anti-thyroid peroxidase (TPO).
* The diagnosis of Hashimoto is based on one or more circulating autoantibodies. The most common are anti-thyroglobulin and anti-thyroid peroxidase (TPO).


</spoiler>
</spoiler>
==Cytologic Features==
* Hurthle cells with intermingled lymphocytes.
* Often colloid is rare or absent.
* Large lymphoid aggregates with germinal centers.






==Additional Teaching Points==
===Immunohistochemistry===
* TTF-1 (nuclear stain)
** Thyroid Transcription factor1 regulates transcription of genes specific to the thyroid, lung, and diencephalon
** If metastatic thyroid cancer to the lung is ruled out by morphology or +thyroglobulin; then a +TTF1 supports adenocarcinoma originating from the lung
* P63 (nuclear stain) and 34BE12 (cytoplasmic stain)
** Used for squamous differentiation
* TTF1 is more sensitive than p63
** If a tumor stains for both it is more likely to be adenocarcinoma
* Napsin A(cytoplasmic stain)
** Granular staining pattern
** Marker for adenocarcinoma


{{Cytologically Yours}}
{{Cytologically Yours}}

Latest revision as of 19:47, 10 January 2014

Clinical History

45 year old female with hypothyroidism.

Cytology

Resident Questions

  • What are the clinical findings that support this diagnosis?
  • Cytologic Features

    • Hurthle cells with intermingled lymphocytes.
    • Often colloid is rare or absent.
    • Large lymphoid aggregates with germinal centers.