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

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==Resident Questions==
===Resident Questions===
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* <spoiler text="Diagnosis?">
* <spoiler text="Diagnosis?">Lymphocytic thyroiditis (Hashimoto thyroiditis). </spoiler>
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* 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>
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==Cytologic Features==
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* Hurthle cells with intermingled lymphocytes.
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* Often colloid is rare or absent.
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* Large lymphoid aggregates with germinal centers.
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==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


Cytologic Features

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