1/25. Fine needle aspiration biopsy of anaplastic thyroid carcinoma developing from a Hurthle cell tumor: a case report.BACKGROUND: Anaplastic thyroid carcinoma is a highly malignant tumor in elderly people with a long history of multinodular goiter and is usually associated with a rapidly fatal clinical evolution. The tumor often develops as a result of anaplastic transformation of a slowly growing papillary carcinoma or follicular neoplasm. CASE: An 85-year-old woman had a multinodular goiter and had been asymptomatic, with a normal white blood cell count and chest radiograph three months prior to her hospital admission for the treatment. The tumor presented with low grade fever, leukocytosis, multiple metastatic lung nodules and enlargement of the intrathoracic thyroid in a period of three months, causing compression of the esophagus and trachea. Despite a total thyroidectomy, the tumor recurred within one month and caused dysphagia and death. CONCLUSION: FNAB permitted the diagnosis of an anaplastic thyroid carcinoma arising from an intrathoracic Hurthle cell tumor.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
2/25. Fine needle aspiration cytology, histology and MIB-1 proliferative index in a case of dyshormonogenetic goitre.The fine needle aspiration (FNA) cytologic findings along with histology and MIB-1 proliferative index in a case of dyshormonogenetic goitre is presented. A 12-year old female child from non-endemic zone presented with a isotopically cold solitary thyroid nodule with a history of goitre being present since birth. Past history of any neck irradiation or maternal ingestion of any goitrogen during the antenatal period and family history of goitre were negative. FNA cytology revealed an extremely cellular preparation with predominantly microfollicular pattern without colloid. Nuclei were round to oval, slightly enlarged with evenly distributed chromatin and inconspicuous nucleoli. Larger tissue fragments also showed foci of solid cell groups with nuclear crowding, overlapping and loss of polarity in addition to the prevalent microfollicular pattern. Occasional tissue fragments showed solid groups of trapped follicular epithelial cells in the matrix of fibrocollagenous tissue. histology showed an intensely hyperplastic follicular cells with nodule formation, irregular fibrosis, pseudo capsular or vascular wall invasion mimicking malignancy. immunohistochemistry for calcitonin was negative but thyroglobulin was positive. MIB-1 (Ki-67) proliferation index varied from 0.05 to 0.26 (mean 0.13) in the hyperplastic nodules versus 0.9 to 2.1 (mean 1.34) in the hyperplastic solid microfoci scattered amidst the grossly normal appearing thyroid tissue. The possible cytologic diagnostic pitfalls in favor of follicular neoplasm is discussed.- - - - - - - - - - ranking = 0.66666666666667keywords = cell (Clic here for more details about this article) |
3/25. Extensive squamous metaplasia in nodular goiter--a diagnostic dilemma in the fine needle aspiration (FNA) cytology--a case report.Metaplastic changes are commonly found at widespread locations occurring in both reactive and neoplastic conditions. They can simulate tumors histologically. Squamous metaplasia is rarely seen in areas of fibrosis and inflammation secondary to hemorrhage in nodular goiters. If it is extensive with associated degenerative changes and present clinically in the form of a nodule, cytopathologist must take care to differentiate this from primary or metastatic squamous cell carcinoma or even anaplastic carcinoma.- - - - - - - - - - ranking = 0.16666666666667keywords = cell (Clic here for more details about this article) |
4/25. Squamous metaplasia in a multinodular goiter: a case report.Squamous epithelium in thyroid is an unusual finding. It is seen in a variety of inflammatory and neoplastic conditions. It's presence has been attributed to metaplastic change of follicular epithelium by some authors and to the persistence of ultimobranchial body by others. We encountered a case of multinodular goiter with groups of squamous cells lining a cystic cavity. We report it because of it's rarity with a brief review of literature.- - - - - - - - - - ranking = 0.16666666666667keywords = cell (Clic here for more details about this article) |
5/25. Neural tumours of the neck presenting as thyroid nodules: a report of three cases.OBJECTIVES: Neural tumours of the neck may at times secondarily involve the thyroid and manifest clinically as thyroid nodules. On cytological evaluation these nodules may be confused with other spindle lesions of the thyroid. We report two cases of schwannoma and one case of a malignant peripheral nerve sheath tumour (MPNST) of the neck, which presented as thyroid nodules and evaluate the role of cytology in identifying these tumours. methods: The thyroid nodules in all the three cases were sampled by the non-aspiration technique using a 23-gauge needle. Both alcohol-fixed and air-dried smears were prepared and stained by the Papanicolaou and May-Grunwald-Giemsa stains. Cytology smears and histology sections from the resected specimens were reviewed, and the findings noted. RESULTS: Both the cases of schwannoma were correctly identified on cytology while the case of MPNST could only be typed as a spindle cell tumour. However, on cytology it was not possible to state whether the tumours were thyroidal or extrathyroidal in origin. CONCLUSIONS: Schwannomas of the neck are easily identifiable on cytology compared with MPNST. However, cytology alone is not helpful in identifying the origin of these tumours. As primary neural tumours of the thyroid are rare, the possibility of a soft tissue neural tumour extending into the thyroid should always be ruled out while evaluating these cases.- - - - - - - - - - ranking = 0.16666666666667keywords = cell (Clic here for more details about this article) |
6/25. Aggressive fibromatosis of the neck initiated after thyroidectomy.We describe the case of a 44-yr-old woman, who 2 yr after thyroidectomy for a multinodular goiter with a follicular adenoma showed a rapidly growing mass of the neck causing dysphagia and moderate pain. Fine needle aspiration biopsy revealed the presence of fibroblast-like cells, partially with atypical features and no colloid: the cytological diagnosis was suspicious for an indeterminate (mesenchymal) neoplasm. Histological diagnosis, after extensive surgery, indicated aggressive fibromatosis. immunohistochemistry was positive for vimentin and negative for thyroglobulin. After surgery, nuclear magnetic resonance showed a persistent mass of approximately 2 cm; dysphagia and pain persisted. Therefore, the patient received external radiation therapy (total dose 60 Gy) with clinical benefit. The patient is without symptoms 1 yr after surgery.- - - - - - - - - - ranking = 0.16666666666667keywords = cell (Clic here for more details about this article) |
7/25. Congenital primary hypothyroidism with subsequent adenomatous goiter in a Turkish patient caused by a homozygous 10-bp deletion in the thyroid peroxidase (TPO) gene.OBJECTIVE: Congenital primary hypothyroidism occurs in 1 of 4000 births. Whereas the majority of the cases are due to developmental defects of the thyroid gland, 20% carry a defect in thyroid hormonogenesis. We report a Turkish boy who had goitrous hypothyroidism due to a mutation in the thyroid peroxidase (TPO) gene. DESIGN: The TPO gene was sequenced directly from genomic dna and cDNA which was transcribed from three rna samples harvested from different parts of the patient's excised thyroid gland. Patient The boy was thyroidectomized because of continuing growth of his thyroid gland and development of multiple nodes suspected of malignancy by ultrasound examination. Histopathological examination verified a dyshormonogenetic goiter with multiple follicular adenomas. RESULTS: The patient had a novel homozygous 10-bp deletion of the TPO gene at position 2812 in exon 16. This frame shift mutation results in a severely altered intracellular part of the protein. The deletion identified in leucocyte dna was also found in thyroid tissue cDNA - so that instability of the transcript or a splicing defect was excluded. Both unaffected parents were heterozygous carriers of the mutation whereas 50 healthy individuals of the same ethnic background did not harbour the mutation. CONCLUSIONS: The identified TPO gene deletion is the first mutation coding for an inactive TPO molecule, which has a severely altered intracellular segment. Because the most likely reason for the enlarging goiter was poor compliance of the patient, this report underlines the importance of a careful and regular follow-up of patients with dyshormonogenesis.- - - - - - - - - - ranking = 0.33333333333333keywords = cell (Clic here for more details about this article) |
8/25. Fine needle aspiration of poorly differentiated oxyphilic (Hurthle cell) thyroid carcinoma: a case report.BACKGROUND: Poorly differentiated oxyphilic (Hurthle cell) carcinomas are a more recently described variant of poorly differentiated thyroid carcinoma and are characterized by a prominent Hurthle cell component in a solid or trabecular arrangement. Clinically, poorly differentiated oxyphilic carcinomas behave more aggressively as compared to classic Hurthle cell carcinomas, which have a predominantly follicular pattern. Although the histology of these rare thyroid tumors has been reported in the literature, the cytologic features on fine needle aspiration biopsy have not been described before. CASE: A 73-year-old man with a long history of radioactive iodine and levothyroxine therapy for multinodular goiter presented with a painful, rapidly expanding, 6-cm, left thyroid mass with aggressive radiologic features. Fine needle aspiration biopsy of the mass yielded extremely cellular smears with a dual population of medium-sized follicular cells and numerous Hurthle cells. Subsequent thyroidectomy confirmed the malignant nature of this Hurthle cell-rich tumor, warranting a diagnosis of poorly differentiated oxyphilic (Hurthle cell) thyroid carcinoma. CONCULSION: Poorly differentiated oxyphilic thyroid carcinoma is an aggressive variant of Hurthle cell carcinomas and must enter the differential diagnosis when fine needle aspiration biopsy of a radiologically aggressive thyroid mass yields extremely hypercellular smears with a prominent Hurthle cell component.- - - - - - - - - - ranking = 2.5keywords = cell (Clic here for more details about this article) |
9/25. Contrast MRI in multiple endocrine neoplasia type 1 (MEN) associated with renal cell carcinoma.The radiologic work-up of a patient with multiple endocrine neoplasia type 1 (MEN 1) syndrome and multiple endocrine nodules, with coincidental renal cell carcinoma, is described. Parathyroid adenoma was differentiated from multiple thyroid nodules by gadolinium-enhanced MRI. Adrenal enlargement due to a nonfunctioning adenoma and a renal cell carcinoma next to a simple renal cortical cyst were identified by typical signal intensities on T1- (pre- and post-Gd-DPTA) and T2-weighted images. insulinoma was visualized only retrospectively.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
10/25. Cowden's disease in three siblings: electron-microscope and immunological studies.Cowden's disease was diagnosed in three siblings (two sisters and a brother) in a Jewish Israeli family of Yemenite origin. The typical mucocutaneous lesions of the disease were present in all three cases. There were hamartomas involving other body systems, including euthyroid multinodular goiter (in all 3 cases), gastrointestinal polyposis (in 2 cases) and hemangioma (in one case). Developmental anomalies were found in all 3 cases. Histological examination of mucocutaneous lesions was in accordance with previous descriptions, including the findings compatible with trichilemmoma observed in cutaneous facial papules. Extensive electron-microscope studies of these facial lesions yielded no evidence of viral particles. Immunological studies, carried out mainly in two cases, revealed a decrease in complement level in the serum and impairment of T cell function.- - - - - - - - - - ranking = 0.16666666666667keywords = cell (Clic here for more details about this article) |
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