Cytologically Yours: Unknowns: 201311: Case 3

Clinical History

32 year old male with a solid thyroid nodule on ultrasound.

Cytology

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Resident Questions

• Diagnosis?

• Papillary carcinoma.

What are the most common molecular associations?

• Rearrangements of Ret proto-oncogene on Chromosome 10 (RET/PTC).
• Point mutations of BRAF and RAS

What other entities of the thyroid may exhibit intranuclear pseudoinclusions?

• Medullary carcinoma.

Cytologic Features

• Powdery chromatin, grooves, pseudoinclusions, nucleolus
• Crowding and overlapping
• Sheets, papillae
• Variable cytoplasm (scant, squamoid, Hurthle-like, vacuolated)
• Psammoma bodies
• Giant cells
• Bubble gum colloid
• Septated cytoplasm