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Presented by Hind Nassar, M.D. and prepared by Rui Zheng, M.D., Ph.D.
Case 1: 50 year old woman with a thyroid nodule.
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Question 1 of 1
1. Question
Week 445: Case 1
50 year old woman with a thyroid noduleimages/1alex/08022010case1image1.jpg
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images/1alex/08022010case1image4.jpgCorrect
Answer: Papillary thyroid carcinoma
Histology: none provided
Discussion: Papillary carcinoma, oncocytic type (Hurthle cell variant of papillary thyroid carcinoma) is relatively uncommon. The tumor has the classic nuclear features of papillary carcinoma; the cytoplasm however is oncocytic (abundant pink granular). It is usually associated with lymphocytic/Hashimoto thyroiditis. It should be differentiated from
1) the tall cell variant of papillary carcinoma which has an aggressive behavior; in the tall cell variant the cells are 3x as tall as they are wide, which is not seen in the oncocytic type,
2) Hurthle cells adenoma in which the nuclear features of papillary carcinoma are absent and there is no evidence of papillary formation,
3) Hurthle cell carcinoma where the lesion is diagnosed by capsular and vascular invasion and also lacks the characteristic nuclear features.Oncocytic variant of papillary thyroid carcinoma has a prognosis similar to that of the conventional papillary carcinoma.
Incorrect
Answer: Papillary thyroid carcinoma
Histology: none provided
Discussion: Papillary carcinoma, oncocytic type (Hurthle cell variant of papillary thyroid carcinoma) is relatively uncommon. The tumor has the classic nuclear features of papillary carcinoma; the cytoplasm however is oncocytic (abundant pink granular). It is usually associated with lymphocytic/Hashimoto thyroiditis. It should be differentiated from
1) the tall cell variant of papillary carcinoma which has an aggressive behavior; in the tall cell variant the cells are 3x as tall as they are wide, which is not seen in the oncocytic type,
2) Hurthle cells adenoma in which the nuclear features of papillary carcinoma are absent and there is no evidence of papillary formation,
3) Hurthle cell carcinoma where the lesion is diagnosed by capsular and vascular invasion and also lacks the characteristic nuclear features.Oncocytic variant of papillary thyroid carcinoma has a prognosis similar to that of the conventional papillary carcinoma.
