PMC6008661_01
Fragments of bone tissue involved by epithelial neoplasia of follicular architecture, with foci of nondifferentiated (insular) carcinoma [Case 1].
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TTF-1, predominantly papillary (follicular variant), however with foci of nondifferentiated (insular) carcinoma (Figures 1 and 2). Thyroid ultrasonography showed a solid nodule of 20 mm in the right lobe and two solid hypoechogenic nodules of 11 and 9 mm in the left lobe, the smallest with coarse calcifications.
Malignant cells revealing intense and diffuse immunoexpression of thyroglobulin (cytoplasmic) (a) and TTF-1 (nuclear) (b) [Case 1].
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TTF-1, predominantly papillary (follicular variant), however with foci of nondifferentiated (insular) carcinoma (Figures 1 and 2). Thyroid ultrasonography showed a solid nodule of 20 mm in the right lobe and two solid hypoechogenic nodules of 11 and 9 mm in the left lobe, the smallest with coarse calcifications.
18F-FDG-PET showing uptake of the radiopharmaceutical drug in thyroid left lobe, L5 vertebrae, and pelvic bones [Case 1].
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No lymphadenopathies were found. 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) revealed a hypermetabolic focus in the left lobe of the thyroid, consistent with the suspected malignant neoplasia, and uptake of the radiopharmaceutical drug in the fifth lumbar vertebra and pelvic bones, consistent with secondary involvement (Figure 3).
Fragments of thyroid involved by papillary thyroid carcinoma of follicular and oxyphilic variants [Case 1].
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Histological examination revealed only follicular and oxyphilic variants of multifocal papillary carcinoma (at least six foci) and none of insular carcinoma, with dimensions ranging from 2 to 15 mm, without signs of hematogenic, lymphatic, or perineural permeation, as well as no signs of invasion of the capsule or extrathyroidal extension, with resection margins uninvolved by tumour (pT1b[m]NxM1R0) (Figure 4).
Posttherapy scintigraphy showing hyperfixation in the remnants of the sacrum and lower lumbar spine, bilateral iliac bone, and anterior cervical region [Case 1].
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Posttherapy scintigraphy showed hyperfixation in the remnants of the sacrum and lower lumbar spine, bilateral iliac bone, and anterior cervical region (Figure 5).
PMC6008661_02
Pelvic CT revealing a 9 cm lytic lesion of left iliac bone [Case 2].
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The patient underwent a pelvic CT, which revealed a 9 cm lytic lesion of left iliac bone with soft tissue involvement (Figure 6).
Fragments of bone tissue involved by epithelial neoplasia of follicular architecture [Case 2].
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TTF-1 showed iliac involvement of a well-differentiated thyroid carcinoma (Figures 7 and 8).
Malignant cells revealing intense and diffuse immunoexpression of thyroglobulin (cytoplasmic) (a) and TTF-1 (nuclear) (b) [Case 2].
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TTF-1 showed iliac involvement of a well-differentiated thyroid carcinoma (Figures 7 and 8).
18F-FDG-PET revealing the pelvic lesion found on CT, without no other metabolically active lesions [Case 2].
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Postablative 131 iodine scintigraphy and 18F-FDG-PET (Figure 9) did not reveal further lesions.