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Presented by Ralph Hruban, M.D. and prepared by Jon Davison, M.D.
Case 4: This woman in her 20’s had a cold nodule in her thyroid.
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Week 188: Case 4
This woman in her 20’s had a cold nodule in her thyroid./images/JMD 6-14-04 SPWC/Case 4/a.jpg
/images/JMD 6-14-04 SPWC/Case 4/b.jpg
/images/JMD 6-14-04 SPWC/Case 4/c.jpgCorrect
Answer: Psammoma bodies highly suspicious for papillary carcinoma
Histology: Several psammoma bodies are present in the above section of thyroid (only one is shown). A mass is not present, and the surrounding thyroid epithelium is benign.
Discussion: Psammoma bodies in the thyroid, or for that matter anywhere in the head and neck region, should strongly suggest the presence of papillary thyroid carcinoma. Indeed, in this case, a small papillary carcinoma was found in an adjacent section of the thyroid. This case hits home that the top three diagnoses for psammoma bodies in the thyroid should be papillary carcinoma, papillary carcinoma, and papillary carcinoma. The discovery of psammoma bodies should prompt a diligent search for papillary carcinoma.
Incorrect
Answer: Psammoma bodies highly suspicious for papillary carcinoma
Histology: Several psammoma bodies are present in the above section of thyroid (only one is shown). A mass is not present, and the surrounding thyroid epithelium is benign.
Discussion: Psammoma bodies in the thyroid, or for that matter anywhere in the head and neck region, should strongly suggest the presence of papillary thyroid carcinoma. Indeed, in this case, a small papillary carcinoma was found in an adjacent section of the thyroid. This case hits home that the top three diagnoses for psammoma bodies in the thyroid should be papillary carcinoma, papillary carcinoma, and papillary carcinoma. The discovery of psammoma bodies should prompt a diligent search for papillary carcinoma.
