PMC9343980_01
US images of the patient's thyroid gland. (A,B) Transverse US views of the left thyroid lobe with arrows pointing at multiple nodules. (C,D) Transverse US views of the right superior and mid thyroid lobe with arrows pointing at multiple nodules. US, ultrasound.
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Ultrasound (US) examination of the goiter confirmed bilateral thyroid nodules up to ~1.6 cm (Figure 1).
Various staining images of components of the synchronous papillary-medullary thyroid microcarcinoma. (A) Low power (40x) and (B) high power (100x) H&E histological images of infiltrative neoplasm with well developed nuclear features of PTC, follicular variant represented by multiple discreet nodules with follicular cells exhibiting nuclear enlargement, elongation and overlapping, chromatin clearing, irregular nuclear contour, nuclear grooves and nuclear pseudoinclusions. (C) Low power (40x) and (D) high power (100x) H&E histological images of MTC represented by a well circumscribed nodule with round to polygonal cells in nests, cords or follicles. Eosinophilic to amphophilic granular cytoplasm. Round centrally located nuclei with coarse chromatin and no nuclear features of PTC. Immunohistochemistry images of MTC represented by (E) strong staining for calcitonin, (F) weak to moderate staining for TTF-1, and (G) strong staining for CK7. H&E, hematoxylin and eosin; PTC, papillary thyroid carcinoma; MTC, medullary thyroid carcinoma; TTF-1, thyroid transcription factor-1; CK7, cytokeratin 7.
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There was also a unifocal medullary carcinoma, AJCC pT1aNx, 0.3 cm in the left lobe (Figure 2).