PMC7372872_01
Scintigraphic image showing a global but heterogeneous hyperfunctioning thyroid gland with excessive uptake at upper left lobe and upper right lobe
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Fig1
A 99mTechnetium scintigraphy (Fig. 1) showed a global, but heterogeneous hyperfunctioning thyroid gland with excessive uptake at the upper left lobe and upper right lobe.
CT image showing a right tracheal deviation by a left thyroid mass
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Fig2
A right tracheal deviation by the left thyroid mass, but no cervical or mediastinal lymphnodes or lung masses, was seen on the CT scan of neck and thorax (Fig. 2).
a Gross pathology (sections). Two separated neoplastic tumors in the left thyroid lobe: follicular thyroid carcinoma (F) (at the top) and papillary thyroid carcinoma (P) (at the bottom). b Two separated morphologically distinct neoplastic tumors in the left thyroid lobe: minimally invasive follicular thyroid carcinoma (F) (to the left) and papillary thyroid carcinoma (P) (to the right) (Hematoxylin and Eosin, original magnification 40x). c Cytonuclear features of papillary thyroid carcinoma, including nuclear overlapping, nuclear grooves ( ) and nuclear clearing ( ) (Hematoxylin and Eosin, original magnification 200x). d Aberrant strong apical membranous (brown coloured) HBME expression in the papillary thyroid carcinoma (original magnification 200x). e Capsular invasion (C) in the follicular thyroid carcinoma (*) (Hematoxylin and Eosin, original magnification 100x). f Angioinvasive growth (V) in the follicular thyroid carcinoma (*) (Hematoxylin and Eosin, original magnification 100x)
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Fig3
Therefore, based on the morphology and immunohistochemistry, a diagnosis of a synchronous minimally invasive follicular thyroid carcinoma (with multifocal capsular invasion and angioinvasion) and a non-encapsulated, infiltrative (classical type) papillary thyroid carcinoma of the left lobe was made (Fig. 3).