practical pathology of thyroid. case 1 a 50 yr old lady presents with a mass in anterior neck slowly...
TRANSCRIPT
PracticalPathologyof Thyroid
Case 1A 50 yr old lady presents
with a mass in anterior neck
Slowly growing since 10 yr ago
Soft and nodular, moves with swallowing
No cervical LAD feltRest of PE is normal
Work - up
Thyroid hormone profile ordered :
TSH : 3.5 IU/L (0.5 – 5 IU/L)
T4 : 6.2 µg/dl (4.5 – 12 µg/dL)T3 : 134 ng/ dl (100 – 220 ng/dL)
T3RU : 24 % (20 - 35 %)
Thyroid scan ordered
Work-upThyroid scan ordered
Thyroid scan
Thyroid FNA performed :
Thyroid FNA
Diagnosis: Multinodular goiterPatient underwent surgery :
Microscopic images
Final diagnosis :
Multinodular
Goiter
Case 2A 45 yr old lady presents with a lump in
anterior part of neck at right thyroid lobeSlowly growing since 4 months ago The mass is firm and indiscrete, and moves
with swallowingOther PEs are normalNo cervical LAD is present She has Hx of Raynaud’s phenomenon
Thyroid hormone profile ordered :
TSH: 7.2 IU/L (0.5 – 5 IU/L)
T4: 4.1 µg/dl (4.5 – 12 µg/dL)
T3: 105 ng/dl (100 – 220 ng/dL)
Thyroid FNA performed :
Microscopic features
Final diagnosis: Hashimoto’s
Thyroiditis
Case 3A 33 yr old man presents with
firmness of his left thyroid lobe and a nodule in left cervical chain growing since 2 wks ago
The latter nodule is softThe left thyroid is firmOther exams are normal
Next work-up step : Thyroid FNA
Diagnosis :Papillary carcinoma of thyroid with cervical lymph node metastasis
Patient underwent total thyroidectomy and left cervical LN resection
Gross and microscopic features
microscopic features
Papillae, psamomma bodies
Final dagnosis: Papillary Carcinoma
of Thyroid