RCPA Examinations in Anatomical pathology - Questions ... - Rcpa.tv

Case 4: Female 42 – right thyroid
nodule
• MICROSCOPIC
• The thyroid contains an encapsulated follicular nodule. The follicular licular structures vary in size and
there appears to be central cystic degeneration within the nodule. The cells are predominantly
low cuboidal with round nuclei containing small inconspicuous nucleoli. Nuclear crowding and
overlapping are not prominent. Nuclear clearing and nuclear grooves oves are not evident. Golden
brown pigment is present in some of the follicular epithelial cells. The fibrous capsule varies in
thickness and in one area there is extension of follicular structures tures into the capsule but not
beyond. However in another area there is a finger-like projections of thyroid follicles which
extends beyond the contours of the capsule into the surrounding thyroid. There still appears to
be a small rim of fibrous tissue surrounding this extension. However the appearance is consistent
with capsular invasion. Vascular invasion is unable to be identified.
ified.
• Comment
• The presence of capsular invasion indicates that this is a minimally invasive follicular carcinoma.
Examination of the remaining capsule of the follicular nodule and d further levels of the area of
capsular invasion will be examined to determine if there is more extensive invasion into the
surrounding thyroid gland.
• SUMMARY
• Thyroid: Minimally invasive follicular carcinoma.