PMC5457633_01
Microscopic appearance of a fine-needle aspiration biopsy and cytological examination of the thyroid. Follicular cells are arranged as sheets, compatible with the smear of a nodular goiter. (Papanicolaou, x40)
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Fig1
A fine-needle aspiration biopsy and cytological examination of the mass revealed follicular cells arranged as sheets or follicles, and hemosiderin-laden macrophages, compatible with the smear of a nodular goiter (Fig. 1).
Macroscopic appearance of a nodule in thyroid tissue. The cut surface revealed a lobulated, infiltrating, and solid gray-whitish tumor, with a thick, focal capsule. Dots outline the poorly differentiated carcinoma component and the arrowheads indicate the nodular goiter
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Fig2
When cut, the nodule's surface showed a lobulated, infiltrating, and solid gray-whitish tumor with a thick, focal capsule (Fig. 2).
Microscopic appearance of a nodule in thyroid tissue. A widely invasive, cellular tumor (asterisks), with a nodular goiter (arrowhead) within a nodule partially encapsulated by a thick fibrous capsule (cap) was noted. (hematoxylin and eosin, x1.25)
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Fig3
Microscopically, a widely invasive, cellular tumor (Fig. 3) was observed, with tumor cells lacking the nuclear features of a papillary thyroid carcinoma and arranged in trabecular, solid, and microfollicular histological patterns (Fig. 4a).
The poorly differentiated thyroid carcinoma showed trabecular, solid and microfollicular histological patterns without the nuclear features of a papillary thyroid carcinoma a, as well as high mitotic activity b. (a-b: hematoxylin and eosin, a: x10, b: x20)
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Fig4
A mitotic activity of four mitoses per 10 high-power fields was noted (Fig. 4b).
The nodular goiter was composed of small or dilated follicles, and lacked the nuclear features of a papillary thyroid carcinoma. (hematoxylin and eosin, x10)
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Fig5
The residual thyroid showed a nodule partially encapsulated by a thick fibrous capsule, and composed of small or dilated follicles but without papillary carcinoma-like nuclear characteristics (Fig. 5).
The Ki-67 labeling index of the nodular goiter was very low a; however, that of the PDTC was high b. (Ki-67 immunostain, a-b: x10)
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Fig6
TTF-1 and PAX-8, and was sparsely scattered, with immunoreactive staining for thyroglobulin and p53 present. The Ki-67 labeling index of the nodular goiter was very low (1.4%; Fig. 6a); however, that of the PDTC was high (20.5%; Fig. 6b). The proportion of PDTC area within the nodular goiter was approximately 50%.