Friday 14th 2011
Previous right hemithyroidectomy ? Recurrent MNG
FNAx6 under ultrasound guidance two nodules left lobe of thyroid (aspirate 1 2&3 upper, aspirate 4 5&6 lower) ten air dried smears prepared.
Smears of aspirates from the upper lesion are hypercellular; in a background of blood numerous follicular epithelial cells in small focally crowded clusters in microacinal groupings, no papillary architectural groups or cells demonstrating intranuclear conclusions or nuclear grooves are seen. Colloid is not a feature
Smears of aspirates from the lower lesion one with abundant thin colloid (lightly blood stained) others numerous macrophages (with granular/pigmented cytoplasm) within a variably stained background with scattered clusters of epithelioid histiocytes and a few groups of follicular epithelial cells including large mono-layered groups with mild anisonucleosis. Occasional groups of Hurthle cells are seen. No papillary architecture groups or cells demonstrating internuclear inclusions or nuclear grooves are seen.
Fine needle aspirate, nodules left lobe of thyroid –
(Upper lesion) ATYPICAL FOLLICULAR PATTERN. Cytologically differential diagnosis includes follicular neoplasm, focus of hyperplasia.
Excision biopsy for histologic diagnosis is recommended.
(Lower lesion) Numerous macrophages, some colloid and follicular epithelial elements in keeping with colloid nodule.
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