PMC7653021_01
Definitive pathology of the thyroid tissue and lymph nodes of the first operation with the microscopy and immunochemistry evaluation: (A) The nests of neoplastic cells were separated by thick septa of fibrous tissue (haematoxylin and eosin, original magnification, x 100); (B) Amyloid deposits around the cell nest (haematoxylin and eosin, original magnification, x 200); (C) Neoplastic cells were strongly immunoreactive for chromogranin A (immunoperoxidase stain for anti-chromogranin A, original magnification, x 100); (D) Neoplastic cells were strongly immunoreactive for synaptophysin (immunoperoxidase stain for anti- synaptophysin, original magnification, x 100); (E) Neoplastic cells were strongly immunoreactive for carcinoembryonic antigen (immunoperoxidase stain for anti- carcinoembryonic antigen, original magnification, x 100); (F) Central lymph node metastasis. (haematoxylin and eosin, original magnification x 200).
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Tg, the Ki-67 index was about 1%. There was 1 out of 5 lymph node metastasis which originated from the primary lesions and had the same histomorphological pattern of the lesions in the central compartment with a cancer nodule detected ( Figure 1 ).
Changes in CEA and Ctn of serum levels from the fisrt operation to the last follow-up.
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However, six months after the first operation, serum CEA levels increased consistently whereas Ctn levels remained normal as showed above ( Figure 2 ).
Definitive pathology of lymph nodes of the second operation with the microscopy and immunochemistry evaluation: (A) Recurrence of lateral cervical lymph nodes (haematoxylin and eosin, original magnification, x 100); (B) Neoplastic cells were negativity immunoreactive for calcitonin (immunoperoxidase stain for anti-calcitonin, original magnification, x 100).
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Lymph nodes in left neck level II, III, and IV showed no metastatic carcinoma (0/17, 0/5, and 0/7 respectively) ( Figure 3 ).