PMC7334388_01
Gross photographs of the lobectomy specimen showing (a) sequential slices from superior to inferior and (b) a closer view of the tan, fleshy, and nodular appearance of the tumor.
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Gross examination (Fig. 1) revealed a 53 g thyroid lobe measuring 6.3 x 5.2 x 4.0 cm, containing a 5.8 cm tumor extending to the inked capsule.
(a) Photomicrograph demonstrating adjacent lymphocytic thyroiditis (hematoxylin and eosin; magnification 100x). (b) Low-power (hematoxylin and eosin; magnification 200x) and high-power (inset; hematoxylin and eosin; magnification 1000x oil immersion) photomicrographs of FL and (c) low-power (hematoxylin and eosin; magnification 200x) and high-power (inset; hematoxylin and eosin; magnification 1000x oil immersion) photomicrographs of DLBCL.
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Microscopic evaluation (Fig. 2) showed diffuse infiltrates of large pleomorphic cells, and areas with nodular infiltrate of small sized cells with irregular nuclei.
(a) Photomicrograph showing FL (arrowhead) and DLBCL (arrow) replacing normal thyroid parenchyma (hematoxylin and eosin; magnification 200x). (b) Ki-67 proliferation index is approximately 20% in the areas involved by FL and 90% in the areas involved by DLBCL (magnification 200x). The neoplastic B-cells are positive for (c) CD20 (magnification 200x) and (d) CD10 (magnification 200x).
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Immunohistochemistry (IHC, Fig. 3), revealed CD20 + B cells which co-expressed CD10, BCL6 and BCL2, but not cyclin 1.