PMC10367547_01
Histopathological analysis of a bifocal mixed presentation of papillary thyroid carcinoma with classic and warthin-like histology in our reported patient. Nodule A: Warthin-like papillary thyroid carcinoma (A1-A4). (A1) Histological examination revealed the presence of branching papillae composed of oncocytic tumor cells amidst a reactive lymphoid stroma (yellow star) (HEx50). (A2) A prominent lymphoplasmacytic infiltrate was identified within the cores of the papillae ( ) (HEx100). (A3) The tumor cells exhibited nuclear enlargement, chromatin clearing, and nuclear groove ( ) (HEx400). (A4) Pseudoinclusions were observed in the nuclei of the tumor cells ( ) (HEx400). Nodule B: Classic papillary thyroid carcinoma (B1-B4). (B1) Classic papillary thyroid carcinoma (black star) was identified invading the thyroid parenchyma (blue star) (HEx50). (B2) The tumor featured a proliferation of complex papillae (HEx100). (B3) The cores of the papillae were identified as fibrovascular without a background of reactive lymphoid stroma (HEx200). (B4) The tumor cells exhibited distinctive papillary nuclear features such as nuclear enlargement and chromatin clearing ( ) (HEx400).
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We pointed out the presence of psammoma bodies and the infiltration into adjacent thyroid tissue ( Figure 1 ).
Microscopic findings of lymph node metastases. Histological examination of lymph node metastases revealed the typical histopathological features of conventional papillary thyroid carcinoma (indicated by the black star) (HE x100).
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The microscopic examination of these lymph nodes was consistent with the histopathological features of conventional PTC, as illustrated in  Figure 2 .