PMC8531091_01
Ultrasound sonogram of the thyroid showed a non-homogenous mass with an unclear boundary, low and moderate echo and rich blood flow signal (A). Enlarged lymph nodes were found in the right neck (B).
fsurg-08-731673-g0001.jpg
PMC8531091_01_fsurg-08-731673-g0001.jpg
F1
Ultrasonography revealed a non-homogenous hypoechoic solid mass, 49 mm x 34 cm in size, with blurred boundaries and a rich blood flow signal, in the right lobe of the thyroid gland (Figure 1A). Several enlarged lymph nodes were found in the right neck (Figure 1B). The following immunohistochemistry staining results were obtained (Figure 3): AE1/AE3 (+), CEA (+), CDX-2 (+), cytokeratin 7 (-), Ki-67 90% (+), calcitonin (-), thyroid transcription factor-1 (-), thyroglobulin (-), synaptophysin (-), chromogranin A (-), and neuron-specific enolase (-).
CT of the neck showed a tumor occupying almost the entire right lobe of the thyroid gland.
fsurg-08-731673-g0002.jpg
PMC8531091_01_fsurg-08-731673-g0002.jpg
F2
Computed tomography (CT) revealed that the tumor occupied almost the entire right lobe of the thyroid gland, with heterogeneous enhancement on the arterial phase (Figure 2).
Haematoxylin and eosin staining showed that the normal thyroid follicles had been destroyed by dispersed tumor cells. Immunohistochemistry showed that AE1/AE3, CEA and CDX-2 stained positive, while CK7, TG, TTF, CT, Syn, CgA, and NSE were absent. The blood vessels (marked with CD31 and CD34) and lymphatic vessels (marked with D2-40) were found to be filled with tumor cells.
fsurg-08-731673-g0003.jpg
PMC8531091_01_fsurg-08-731673-g0003.jpg
F3
The following immunohistochemistry staining results were obtained (Figure 3): AE1/AE3 (+), CEA (+), CDX-2 (+), cytokeratin 7 (-), Ki-67 90% (+), calcitonin (-), thyroid transcription factor-1 (-), thyroglobulin (-), synaptophysin (-), chromogranin A (-), and neuron-specific enolase (-).