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Pathology Report UPMC

Oct 27, 2008 - 0 comments

pathology report

Thank you for sharing this most challenging case with us. In our opinion the larger nodule represents an oncocytic follicular variant of papillary carcinoma. The follicles present within this lesion are large in caliber and are lined by cells that are though oncocytic, show nuclear features, namely enlargement clearing elongation, overlap, and membrane irregularities (particularly on slide A4), that are compatible with the below diagnosis.

Additionally we found at least three incidental foci of papillary  thyroid microcarcinoma present on A3 and A5 (your original slides), and A4 (our recut)

Part 1: Thyroid, right lobe, lobectomy (8.3 grams) (OSS S08-7463, 10/21/2008)
     A. Papillary thyroid Carcinoma, oncocytic variant (1.5cm)
     B. Three additional foci of papillary thyroid microcarcinoma (Range : less than 0.1 cm to 0.1cm)
     C: No angiolymphatic invasion present, all foci confined to thyroid.
     D: Intrathyroidal thymus.

Part 2: Parathyroid, right excision (8.3 grams)
     A. Normocellular parathyroid
     B. Thymus with no significant Abnormalities.

Right subtotal thyroidectomy DRMC

Oct 21, 2008 - 1 comments

right subtotal thyroidectomy



Surgeon: Gregory J. Roscoe MD
PREOP DIAGNOSIS: Right thyroid mass approximately 1.8 cm. skinny needle biopsy benign.
POSTOP DIAGNOSIS: Same, with an area less that 5 mm, could be papillary carcinoma variant.
OPERATION/PRODECURE: Right subtotal thyroidectomy with recurrent nerve dissection and Stryker drain place and secured. Frozen section.

TECHNIQUE: The patient was brought to the operating room and identified. Under endotracheal anesthesia the patient was adequately anesthetized. On evaluation of the neck, the patient did have fullness to the right lobe of the thyroid. The patient was prepped and draped in the usual sterile manner. A curvilinear incision was then made and taken down through the skin and subcutaneous tissues. Strap muscles were divided in the midline. Overall, dissection was then carried into the right lobe of the thyroid. The patient had a lrge mass as noted, approximately 2 cm within the lobe of the thyroid, and a small additional lobe perithyroid; apparently a benign looking parathyroid adenoma. The right lobe was dissected in the usual fashion dissecting in the midline as well as sacrificing the superior, middle and inferior lobe vasculature as well as identifying the recurrent nerve and following it to insertion in the lateral aspect of the larynx. The left lobe, overall, felt extremely soft and regular even though scanning revealed some nodularity. At that poin the lobe was submitted. A small parathyroid was reimplated on the right side. At that point the frozen section revealed a benigh adenoma within the thyroid. However, the adjacent piece appeared to be, at this point, difficult to call but a variant of papillary carcinoma. Further studies are pending. A small bit of Arista was placed as well as a Stryker darin was placed and secured with 2-0 silk. Closure was accomplised with mattress stitches of 3-0 chromic as well as skin staples. A pressure dressing was placed as well as foam tape used.

labs ERMC

Oct 13, 2008 - 0 comments








Calcium 10.0
FT1 (T7) 2.8

Skinny Needle/FNA Post-op

Oct 08, 2008 - 0 comments

skinny needle



Post-op/Dr. Roscoe.
FNA showed no cancer. There is a tumor with odd cells. Because of the growth of nodule from '06 to present, I should have the right side of thyroid removed. Tumors are taking up the whole right side, so remove it. After, they will need to check hormones weekly.
Surgery-When he performs surgery there will be a pathologist right there to check it for cancer...if any is found he will remove the whole thyroid.
Right side removal scheduled for 10/21. stay overnite. STOP Vit E & Fish Oil.