Cytologically Yours: Unknowns: 201311: Case 3

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Clinical History

32 year old male with a solid thyroid nodule on ultrasound.

Cytology

Resident Questions

  • <spoiler text="Diagnosis?">
  • Papillary carcinoma. </spoiler>
  • <spoiler text="What are the most common molecular associations?">
  • Rearrangements of Ret proto-oncogene on Chromosome 10 (RET/PTC).
  • Point mutations of BRAF and RAS </spoiler>
  • <spoiler text="What other entities of the thyroid may exhibit intranuclear pseudoinclusions?">
  • Medullary carcinoma. </spoiler>

Cytologic Features

  • Powdery chromatin, grooves, pseudoinclusions, nucleolus
  • Crowding and overlapping
  • Sheets, papillae
  • Variable cytoplasm (scant, squamoid, Hurthle-like, vacuolated)
  • Psammoma bodies
  • Giant cells
  • Bubble gum colloid
  • Septated cytoplasm
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