Practical
Pathology
of Thyroid
Case 1
 A 50 yr old lady
presents with a mass in
anterior neck
 Slowly growing since
10 yr ago
 Soft and nodular,
moves with swallowing
 No cervical LAD felt
 Rest of PE is normal
Work - up
 TSH : 3.5 IU/L
(0.5 – 5 IU/L)
 T4 : 6.2 µg/dl
 Thyroid
(4.5 – 12 µg/dL)
hormone profile  T3 : 134 ng/ dl
ordered :
(100 – 220 ng/dL)
 T3RU : 24 %
(20 - 35 %)
Thyroid scan ordered
Work-up
Thyroid
scan
ordered
Thyroid scan
Thyroid FNA performed :
Thyroid FNA
Diagnosis: Multinodular goiter
Patient underwent surgery :
Microscopic images
Final diagnosis :
Multinodular
Goiter
Case 2
 A 45 yr old lady presents with a lump in
anterior part of neck at right thyroid lobe
 Slowly growing since 4 months ago
 The mass is firm and indiscrete, and
moves with swallowing
 Other PEs are normal
 No cervical LAD is present
 She has Hx of Raynaud’s phenomenon
Thyroid hormone profile ordered :
TSH: 7.2 IU/L (0.5 – 5 IU/L)
T4: 4.1 µg/dl
(4.5 – 12 µg/dL)
T3: 105 ng/dl (100 – 220 ng/dL)
Thyroid FNA performed :
Microscopic features
Final diagnosis:
Hashimoto’s
Thyroiditis
Case 3
A 33 yr old man presents with
firmness of his left thyroid lobe
and a nodule in left cervical
chain growing since 2 wks ago
The latter nodule is soft
The left thyroid is firm
Other exams are normal
Next work-up step : Thyroid FNA
Diagnosis :
Papillary carcinoma of thyroid
with cervical lymph node
metastasis
Patient underwent total
thyroidectomy and left cervical
LN resection
Gross and microscopic features
microscopic features
Papillae, psamomma bodies
Final dagnosis:
Papillary
Carcinoma
of Thyroid