Cytologically Yours: CoW: 20140220
The patient is a 58 year old male with back and neck pain.
Past Medical History
- Cervical spondylosis
Past Surgical History
- No surgical history
- Ultrasound of the neck shows a solid interpolar nodule 1.8 x 1.6 cm in the left lobe of the thyroid.
Fine needle aspiration of the nodule is scheduled.
In a cellular thyroid lesion, follicular neoplasm, including adenoma and carcinoma, and cellular benign follicular nodule are in the differential. Also in the differential is the follicular variant of papillary carcinoma.
"> Follicular carcinoma show PAX8-PPAR gamma translocations and papillary carcinoma shows BRAF mutations and RET/PTC rearrangements.
- Follicular neoplasm.
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.