21/25. Multinodular goiter of the thyroid mimicking malignancy: diagnostic pitfalls in fine-needle aspiration biopsy.A case of multinodular goiter with multicentric papillary hyperplasia is presented with cytologic features suggestive of thyroid papillary carcinoma. While the cytologic criteria for papillary thyroid carcinoma is well defined, occasional diagnostic difficulties can arise. Cytologically, the presence of focal papillary aggregates, the presence of a psammoma body within a background of copious colloid and scattered follicular cells led to diagnostic confusion. Histologically, the presence of secondary follicles in the papillae and protrusion of the papillary structures into colloid lakes supported the diagnosis of goiter. It is our opinion that most, if not all, of these difficulties can be circumvented by the incorporation of all major and some minor cytologic criteria for papillary carcinoma in the analysis of such lesions. Single criteria for papillary carcinoma, either major or minor, is not sufficient.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
22/25. Sporadic medullary thyroid carcinoma associated with toxic multinodular goitre.First described in 1959, medullary thyroid carcinoma (MTC) arises from parafollicular C cells distributed throughout the thyroid, and may occur in one of two clinical forms, sporadic (80%) or familial. Familial MTC may present as a palpable thyroid nodule, but may also be diagnosed by screening relatives of an index case for a raised basal serum calcitonin or a rise in calcitonin following a stimulated pentagastric test. Both tests are highly sensitive for C-cell hyperplasia and MTC. Sporadic cases of MTC most commonly present as asymptomatic thyroid nodules with normal thyroid function tests. In this note, the history of a patient is presented in which a sporadic MTC was associated with goitre and both symptoms and biochemical evidence of thyrotoxicosis.- - - - - - - - - - ranking = 2keywords = cell (Clic here for more details about this article) |
23/25. Ectopic thyroid tissue in the neck. Benign or malignant?This is a report of ectopic thyroid tissue in the neck, associated with a nodular colloid goiter, which recurred at least three times, beginning at age 24 years, in a woman in 12 years. The ectopic tissue appeared histologically benign and was identical to that found in the thyroid gland. Scintiscans of the neck and thyroid suppression tests showed that the tissue was initially unsuppressible and presumably autonomous in its function. Our conclusion is that the most reasonable explanation for this phenomenon is the intraoperative transmission of thyroid cells, probably benign and autonomous in function, to other sites in the neck.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
24/25. Ectopic multinodular goitre.A 61-year-old man presented with a slowly enlarging lateral neck mass. There was no other associated ENT symptoms. Clinical examination was unremarkable. The pan endoscopy was normal. The mass when excised was found to be subplatysmal. The histology was that of a multinodular thyroid tissue. Subsequent investigations showed normally placed thyroid with multinodular changes. Laterally placed thyroid tissue have been reported since the 18th century. Initially, they were found to contain malignant tissue and hence the term lateral aberrant thyroid tumours. In later years, benign ectopic thyroid tissue was described in the lateral neck. It is now felt that ectopic thyroid tissue are derived from thyroid cell rests that have failed to fuse with the main thyroid tissue during development. They are subjected to the same goitrogenic stimulation as the normally placed thyroid tissue. Our case supports the view that not all laterally placed thyroid tissue are malignant.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
25/25. Primary and secondary carcinomata with focal nodular hyperplasia in a multinodular thyroid: case report.A patient is described whose multinodular thyroid gland was found to have a primary papillary adenocarcinoma, a metastatic renal-cell carcinoma, and focal nodular hyperplasia. To our knowledge, this is the first case report of such an unusual combination. In a patient with known malignancy elsewhere, the possibility that a recent thyroid mass may be a metastasis should be considered.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
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