PMC5156800_01
(a) Thyroid nodule, large (29 x 44 x 31 mm transverse, longitudinal, and anteroposterior diameters, resp.) hypoechogenic heterogeneous thyroid nodule with regular borders; (b) lymph node, large (48 x 20 mm), hypoechoic, partly cystic lymph node.
CRIE2016-8756723.001.jpg
PMC5156800_01_CRIE2016-8756723.001.jpg
fig1
Imaging documented a large (29 x 44 x 31 mm transverse, longitudinal, and anteroposterior diameters, resp.), hypoechogenic, heterogeneous thyroid nodule of the left lobe with regular borders (Figure 1) superimposed on a micronodular background and multiple locoregional (left posterior and internal jugular) lymphadenopathies of large dimensions (the largest with 48 x 20 mm diameter) (Figure 2).
3: FNA of the thyroid with follicular cells with suspicious nuclei (anisokaryosis, longitudinal grooves) on the background of a lymphocytic thyroiditis (Papanicolaou stain, 400x); 4: macroscopy features of the surgical specimens: left hemithyroidectomy (on top) and left cervical lymph node (on the bottom); 5: thyroid parenchyma with a diffuse infiltration of a lymphoid neoplasm (HE, 40x). These features were also found on the lymph node (not shown); 6: the neoplasm consisted of irregular nodules of follicular dendritic cells (CD21, 40x); 7: extensive background of CD4+ T-lymphocytes (CD4, 40x); 8: intermingled scattered large "popcorn cells" could be observed (HE, 200x); 9: the neoplastic popcorn cells were positive for CD20 (CD20, 200x); 10: they were negative for CD30 (CD30, 200x) and CD15 (not shown).
CRIE2016-8756723.002.jpg
PMC5156800_01_CRIE2016-8756723.002.jpg
fig2
Imaging documented a large (29 x 44 x 31 mm transverse, longitudinal, and anteroposterior diameters, resp.), hypoechogenic, heterogeneous thyroid nodule of the left lobe with regular borders (Figure 1) superimposed on a micronodular background and multiple locoregional (left posterior and internal jugular) lymphadenopathies of large dimensions (the largest with 48 x 20 mm diameter) (Figure 2). Immunohistochemistry of the neoplastic cells showed positivity for CD20 and negativity for CD30 and CD15 (Figure 2).