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Thyroid Cytopathology
Unknown Cases For Discussion
Syed Z. Ali, M.D.
The Johns Hopkins Hospital, Baltimore,
Maryland
Case 1
 A 46 year-old woman with a 3.2 cm solid, left thyroid nodule present for
2 years. There has been a recent increase in the size of the nodule. Family
history is positive for papillary thyroid carcinoma in the mother, who is alive
and free of disease.
Ultrasound-guided FNA. Smears stained with Diff-Quik stain.
Case 2
 A 55 year-old man with a 3.0 cm solid, right thyroid nodule present for
less than 3 months. The nodule shows coarse calcifications, which radiographically,
are thought to be suspicious for papillary thyroid carcinoma.
Ultrasound-guided FNA. A flow cytometry was ordered after on-site evaluation.
Smears stained with Diff-Quik and Papanicolaou stains.
Case 3
A 62 year-old woman presents with a 1.2 cm left lobe thyroid nodule.
Past medical history reveals a cavernous sinus meningioma 17 years ago
treated with subtotal resection and external beam radiation therapy. The
thyroid nodule was discovered incidentally on routine imaging studies. The
nodule was noted to have a hypoechoic rim and small, punctate, echogenic
foci that were suggestive of microcalcifications.
Ultrasound-guided FNA. Smears stained with Diff-Quik and Papanicolaou stains.
Case 4
 A 28 year-old woman with an incidentally discovered 1.8 cm solid, left thyroid
nodule. She complains of bone pain, worsening fatigue and lethargy.
Ultrasound-guided FNA. Smears stained with Diff-Quik and Papanicolaou stains.
Case 5
A 61 yr-old man was evaluated for a slow-growing left thyroid mass that was
present for 2 yr despite thyroid hormone suppression. Thyroid-stimulating
hormone (TSH) was within normal limits. Past history was significant for
radium treatment of his adenoid at age 6.
Ultrasound-guided FNA. Smears stained with Diff-Quik and Papanicolaou stains.