Transcript CASE 1: FNA OF A LARGE GOITRE Roberto Dina, MD Cytology

CASE 1: FNA OF A LARGE
GOITRE
Roberto Dina, MD
Cytology
Dept of Histopathology
Hammersmith Hospital
London (U.K.)
CASE HISTORY
• A 77 yr old Female with a history of long
standing goitre
• Presents with a recently enlarged thyroid
• Smoker
Imaging
• Large heterogeneous mass within the neck
consistent with the patients goitre. The trachea
is markedly deviated to the right and narrowed
in the coronal dimension to 6 mm. The goitre
extends to the superior aspect of the sternum.
Within the anterior segment of the LUL there is
a spiculated 11 mm diameter nodule which
appears to be cavitating anteriorly.
Bronchoscopy
• Bronchoscopy normal
• Bronchial washing and brushing
Negative for malignant cells
FNA PERFORMED
• 4 Passes (27 G needle)
• Scanty Material
Isolated atypical nuclei
lymphocytes
CYTOLOGY
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Necrotic Background
Multinucleated Giant Cells
Histiocyte like cells
Atypical Cells
Aggregates of Lymphocytes