PMC5884408_01
Time course of thyroglobulin (Tg), thyroglobulin antibody (TgAb), and TSH after initial treatment of papillary thyroid cancer.
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One year after total thyroidectomy and radioiodine therapy, she had persistently elevated thyroglobulin (Tg) level of 11.4 ng/dL (3-40) with undetectable thyroglobulin antibodies (TgAb) (Figure 1). Tg still measured 7.1 ng/mL with undetectable TgAb and suppressed TSH. The patient had sporadic follow-up with our clinic, but subsequent Tg levels over the next 10 years gradually declined (Figure 1) with undetectable TgAb and suppressed TSH.
Metastatic papillary thyroid cancer in a lymph node. (a) Ultrasound image of the lymph node (arrow). (b) Cytological features of cells (Giemsa stain) obtained from the lymph node by fine-needle aspiration. Note the cytological features typical of papillary thyroid cancer cells. See text for detail.
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Neck ultrasound showed several lymph nodes on the left lateral neck and left submandibular region, measuring 0.5 cm to 0.8 cm (Figure 2). Cytology showed moderately cellular, scattered clusters and sheets of moderately atypical epithelial cells with irregular nuclear contours, nuclear grooving, and numerous intranuclear pseudoinclusions, diagnostic of metastatic papillary thyroid carcinoma (Figure 2).