Oct 27, 2008
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.