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Pathology Education Instructional Resource β

Cytologically Yours: CoW: 20140220

Contents

Clinical Summary

The patient is a 58 year old male with back and neck pain.

Past Medical History

  • Cervical spondylosis
  • Hypertension
  • Hyperlipidemia

Past Surgical History

  • No surgical history

Radiology

  • Ultrasound of the neck shows a solid interpolar nodule 1.8 x 1.6 cm in the left lobe of the thyroid.

Clinical Plan

Fine needle aspiration of the nodule is scheduled.

Pathology

Cytology


Resident Questions


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Final Diagnosis

Cytology

  • Follicular neoplasm.


Discussion

The diagnostic criteria for follicular lesions are based on cellularity and the presence of colloid. Follicular lesions will be cellular with an absence of the variability in the size of the follicular groups, with a predominately microfollicular pattern. Colloid will be scant to absent, except for the presence of inspissated colloid in the center of follicular groups. There is often a disorganized, crowded follicular pattern with some nucleomegaly and nucleoli.