PMC9850096_01
Hematoxylin and eosin (HE) stained FNAB of thyroid lobe (A), 20x magnification) revealed malignant epithelial cells. IHC staining showed that malignant cells in thyroid were positive for G-3 (B), 20x magnification), and negative for TTF1 (C), 20x magnification), TG (D), 20x magnification).
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We showed on computed tomography (CT) that the thyroid gland was unclear and there were lymph node metastases in the neck and upper mediastinum ( Figure 1  ).
Computed tomography (CT) images showing that the size of the lesions had decreased. (A) Before treatment with dabrafenib and trametinib. (B) Dabrafenib and trametinib for 5 days. (C) Dabrafenib and trametinib for 19days. (D) Dabrafenib and trametinib for 50days.
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PMC9850096_02
Computed tomography (CT) images showing that the size of the lesions had decreased. (A, D). CT images of the metastatic lesions in the lung and neck respectively, before treatment with dabrafenib and trametinib. (B, C, E, F). CT images of the metastatic lesions after treatment with dabrafenib and trametinib.
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Nodules of varying size were scattered throughout both lungs, with the largest nodule measuring 1.8 cm in diameter, which we suspect to be metastatic lesions (  Figure 3  ).
Hematoxylin and eosin (HE) stained FNAB of thyroid lobe (A), 20x magnification) revealed malignant epithelial cells. IHC staining showed that malignant cells in thyroid were positive for BRAR-VE (B), 20x magnification) and G-3 (C), 20x magnification) and CK19 (D), 20x magnification).
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Combined the morphology and all of the above findings led to a diagnosis of PTC with a mutation at position 228 of the TERT gene promoter (  Figure 4  ).