PMC4150345_01
Cellular aspirate with acinar cells, papillaroid clusters, and nuclei with grooves (H and E, x200)
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PMC4150345_01_JCytol-31-53-g001.jpg
F1a
The FNAC revealed a cellular aspirate composed of cells arranged in numerous acini, loose clusters, pseudopapillae, as well as singly dispersed [Figure 1a]. Many cells showed nuclear grooves as well as marked anisonucleosis, with occasional intranuclear cytoplasmic inclusions [Figure 1c]. The cytoplasm was abundant, pink, and granular in most of the cells [Figure 1b]. A pink amorphous acellular material was identified as large blobs and stained positive for Congo red [Figure 1d].
Acini composed of pleomorphic cells with hyperchromatic nuclei and abundant pink cytoplasm (H and E, x400)
JCytol-31-53-g002.jpg
PMC4150345_01_JCytol-31-53-g002.jpg
F1b
The cut surfaces of both were nodular and fleshy in appearance [Figure 2a]. The multiple sections studied, revealed diffuse atypical plasma cells in sheets effacing the normal thyroid parenchyma [Figure 2b]. The intervening areas and thyroid tissue at the periphery showed Hashimoto thyroiditis, with extensive oncocytic change and bizarre nuclear changes. Immunohistochemistry revealed plasmacytoid cells with diffuse positivity for CD138 [Figure 2c], and also cytoplasmic positivity for the Kappa light chain. The tumor cells were negative for CD19 [Figure 2d] and CD20.