Meeting di citologia e patologia tiroidea

Casi che capitano Giacomo Gazzano Sonia Palazzo Milano 17 maggio 2019

Caso 1

Notizie cliniche

Uomo di 54 anni

Si esegue agoaspirato di un nodulo tiroideo (destro)

solido ipoecogeno ben definito e

con lacune interne senza sospetti ecografici e di cm 18

a) pattern sinciziale b) follicolare c) rosettiforme

a

b c

Caso 1 analisi morfologica

Diagnosi citologica 1) Pattern crescita 2) Pigmento 3) Pseudoinclusi 4) Assenza di colloide

Caso 1Diagnosi differenziale Medullary carcinoma

Neoplasie follicolari

Carcinoma papillare

Carcinoma tiroideo scarsamente differenziato

Carcinoma anaplastico

Melanoma

Paratiroide

Paraganglioma

Neoplasia follicolare

Carcinoma papillare

Carcinoma anaplastico Carcinoma scarsamemte differenziato

PARATIROIDE

PARAGANGLIOMA

META MELANOMA

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 1

Notizie cliniche

Uomo di 54 anni

Si esegue agoaspirato di un nodulo tiroideo (destro)

solido ipoecogeno ben definito e

con lacune interne senza sospetti ecografici e di cm 18

a) pattern sinciziale b) follicolare c) rosettiforme

a

b c

Caso 1 analisi morfologica

Diagnosi citologica 1) Pattern crescita 2) Pigmento 3) Pseudoinclusi 4) Assenza di colloide

Caso 1Diagnosi differenziale Medullary carcinoma

Neoplasie follicolari

Carcinoma papillare

Carcinoma tiroideo scarsamente differenziato

Carcinoma anaplastico

Melanoma

Paratiroide

Paraganglioma

Neoplasia follicolare

Carcinoma papillare

Carcinoma anaplastico Carcinoma scarsamemte differenziato

PARATIROIDE

PARAGANGLIOMA

META MELANOMA

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

a) pattern sinciziale b) follicolare c) rosettiforme

a

b c

Caso 1 analisi morfologica

Diagnosi citologica 1) Pattern crescita 2) Pigmento 3) Pseudoinclusi 4) Assenza di colloide

Caso 1Diagnosi differenziale Medullary carcinoma

Neoplasie follicolari

Carcinoma papillare

Carcinoma tiroideo scarsamente differenziato

Carcinoma anaplastico

Melanoma

Paratiroide

Paraganglioma

Neoplasia follicolare

Carcinoma papillare

Carcinoma anaplastico Carcinoma scarsamemte differenziato

PARATIROIDE

PARAGANGLIOMA

META MELANOMA

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 1 analisi morfologica

Diagnosi citologica 1) Pattern crescita 2) Pigmento 3) Pseudoinclusi 4) Assenza di colloide

Caso 1Diagnosi differenziale Medullary carcinoma

Neoplasie follicolari

Carcinoma papillare

Carcinoma tiroideo scarsamente differenziato

Carcinoma anaplastico

Melanoma

Paratiroide

Paraganglioma

Neoplasia follicolare

Carcinoma papillare

Carcinoma anaplastico Carcinoma scarsamemte differenziato

PARATIROIDE

PARAGANGLIOMA

META MELANOMA

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 1Diagnosi differenziale Medullary carcinoma

Neoplasie follicolari

Carcinoma papillare

Carcinoma tiroideo scarsamente differenziato

Carcinoma anaplastico

Melanoma

Paratiroide

Paraganglioma

Neoplasia follicolare

Carcinoma papillare

Carcinoma anaplastico Carcinoma scarsamemte differenziato

PARATIROIDE

PARAGANGLIOMA

META MELANOMA

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Neoplasia follicolare

Carcinoma papillare

Carcinoma anaplastico Carcinoma scarsamemte differenziato

PARATIROIDE

PARAGANGLIOMA

META MELANOMA

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Diagnosi citologica

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

Profilo immunofenotipico

TTF1

CRA

CALCITONINA

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Diagnosi citologica

Cellularitagrave abbondante

Cellule tumorali maligne di aspetto fusato

Emazie

TIR 5

Quadro morfologico ed immunofenotipico

coerente con carcinoma midollare

DIAGNOSI CITOLOGICA

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 1 conferma istologica

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma midollare con aspetti a cellule fusatehelliphelliphelliphelliphelliphellip Non angioinvasione Capsula e margini indenni Linfonodi indenni Stadio TNM pT1b N0

Dato molecolare ottenuto su congelato del pezzo operatorio

Riarrangiamenti Ret wt

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 2

Notizie cliniche

Donna di 82 anni

Si esegue agoaspirato del nodulo tiroideo sinistro che appare

molto duro alla palpazione e di cm 5 Da segnalare che la paziente

presenta tiroide ipoecogena come da tireopatia autoimmune

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 2Diagnosi differenziale

Carcinoma adenoido-cistico

Adenoma ialinizzante trabecolare

Carcinoma papillare (variante follicolare cribriforme-morulare)

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

TG

S100 MGG

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Adenoido-cistico

CARCINOMA PAPILLARE

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

DIAGNOSI CITOLOGICA

Cellularitagrave abbondante Tireociti in aggregati in parte follicolari ed in parte solidi occasionalmente con chiarificazioni Nucleari Presenza di sostanza metacromatica al May-Grumwald-Giemsa Tir 4 Reperto citologico sospetto per malignitagrave da tipizzare istologicamente

Caso 2

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

DIAGNOSI ISTOLOGICA

Caso 2

Carcinoma follicolare estesamente invasivo con invasione dei tessuti molli e angioinvasione Metastasi ai tessuti molli del collo Stadio TNM pT4a Nx

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 2 diagnosi differenziale Cytopathology 2010 Apr21(2)93-6 doi 101111j1365-2303200900654x Epub 2009 May 14

Adenoid cystic pattern in follicular variant of papillary thyroid carcinoma a report of four cases

Mandal S1 Jain S

An adenoid cystic pattern in thyroid tumours is a rare finding that may be seen in papillary carcinoma of thyroid (PCT)

the follicular variant of PCT (FV-PCT) a rare cribriform-morular variant of papillary carcinoma of thyroid (CMV-PCT)

and follicular carcinoma There is little published cytological literature describing these patterns We report four cases

of PCT with this unusual pattern

The patients were female and ranged in age from 18 to 46thinspyears They presented with a gradually increasing mass in

the neck FNA smears in all cases showed nuclear features of PCT There were also prominent follicular areas with

hyaline globules in some of the cell clusters reminiscent of adenoid cystic carcinoma and in places morula-like groups

of neoplastic cells were also seen Immunocytochemistry for thyroglobulin was positive in all cases but negative in the

hyaline globules

Adenoid cystic areas with morula-like groups in PCT are a rare finding Cytopathologists and clinicians should be

aware of these distinct features in thyroid tumours to avoid diagnosing metastatic adenoid cystic carcinoma It is also

important to rule out CMV-PCT since that variant is mostly associated with familial adenomatous polyposis although

sporadic occurrence is known

Caso 3

Notizie cliniche

Donna di 76 anni

Nodulo sinistro di consistenza dura a margini mal definiti di cm 9

Allrsquoingresso dellrsquoago consistenza simil sughero

Nodulo ecograficamente sospetto

Caso 3 diagnosi differenziale

Carcinoma scarsamente differenziato della tiroide Citoarchitettura solida insulare o trabecolare Popolazione omogenea Alto rapporto nc con lievi asimmetrie Colloi scarsa Mitosi presenti Necrosi presente

httpsicytologywordpresscom

Carcinoma indifferenziato della tiroide Scarsamente coesive Epieliodi con forme fusate giganti e osteoclastic-like Necrosi estesa Estesa infiammazione TTF1 e Tireoglobulina negative

Cellularitagrave abbondante Tireociti in agregati in parte con citoplasmi ossifili e dismetrie nucleari Scarsa coloide TIR4

Caso 3 diagnosi citologica

Criteri di Torino derivazione follicolare solido trabecolare o pattern insulare

Criteri di Torino assenza di aspetti papillari almeno uno gt 3 mitosi X10HPF necrosi o nuclei convoluti

Caso 3 Diagnosi istologica

Carcinoma tiroideo scarsamente differenziatohelliphelliphelliphelliphelliphelliphelliphelliphellip Estensione ai tessuti molli helliphelliphelliphelliphelliphelliphelliphellipinvasione vascolarehellipmargine positivohellipmetastasi linfonodali Stadio TNM pT4a N1b

Caso 3 diagnosi differenziale

Carcinoma scarsamente differenziato della tiroide Citoarchitettura solida insulare o trabecolare Popolazione omogenea Alto rapporto nc con lievi asimmetrie Colloi scarsa Mitosi presenti Necrosi presente

httpsicytologywordpresscom

Carcinoma indifferenziato della tiroide Scarsamente coesive Epieliodi con forme fusate giganti e osteoclastic-like Necrosi estesa Estesa infiammazione TTF1 e Tireoglobulina negative

Cellularitagrave abbondante Tireociti in agregati in parte con citoplasmi ossifili e dismetrie nucleari Scarsa coloide TIR4

Caso 3 diagnosi citologica

Criteri di Torino derivazione follicolare solido trabecolare o pattern insulare

Criteri di Torino assenza di aspetti papillari almeno uno gt 3 mitosi X10HPF necrosi o nuclei convoluti

Caso 3 Diagnosi istologica

Carcinoma tiroideo scarsamente differenziatohelliphelliphelliphelliphelliphelliphelliphelliphellip Estensione ai tessuti molli helliphelliphelliphelliphelliphelliphelliphellipinvasione vascolarehellipmargine positivohellipmetastasi linfonodali Stadio TNM pT4a N1b

Cellularitagrave abbondante Tireociti in agregati in parte con citoplasmi ossifili e dismetrie nucleari Scarsa coloide TIR4

Caso 3 diagnosi citologica

Criteri di Torino derivazione follicolare solido trabecolare o pattern insulare

Criteri di Torino assenza di aspetti papillari almeno uno gt 3 mitosi X10HPF necrosi o nuclei convoluti

Caso 3 Diagnosi istologica

Carcinoma tiroideo scarsamente differenziatohelliphelliphelliphelliphelliphelliphelliphelliphellip Estensione ai tessuti molli helliphelliphelliphelliphelliphelliphelliphellipinvasione vascolarehellipmargine positivohellipmetastasi linfonodali Stadio TNM pT4a N1b

Criteri di Torino derivazione follicolare solido trabecolare o pattern insulare

Criteri di Torino assenza di aspetti papillari almeno uno gt 3 mitosi X10HPF necrosi o nuclei convoluti

Caso 3 Diagnosi istologica

Carcinoma tiroideo scarsamente differenziatohelliphelliphelliphelliphelliphelliphelliphelliphellip Estensione ai tessuti molli helliphelliphelliphelliphelliphelliphelliphellipinvasione vascolarehellipmargine positivohellipmetastasi linfonodali Stadio TNM pT4a N1b

Criteri di Torino assenza di aspetti papillari almeno uno gt 3 mitosi X10HPF necrosi o nuclei convoluti

Caso 3 Diagnosi istologica

Carcinoma tiroideo scarsamente differenziatohelliphelliphelliphelliphelliphelliphelliphelliphellip Estensione ai tessuti molli helliphelliphelliphelliphelliphelliphelliphellipinvasione vascolarehellipmargine positivohellipmetastasi linfonodali Stadio TNM pT4a N1b

Caso 3 Diagnosi istologica

Carcinoma tiroideo scarsamente differenziatohelliphelliphelliphelliphelliphelliphelliphelliphellip Estensione ai tessuti molli helliphelliphelliphelliphelliphelliphelliphellipinvasione vascolarehellipmargine positivohellipmetastasi linfonodali Stadio TNM pT4a N1b