Remegio J. Maglantay Jr., MD; Yuri E. Nikifirov, MD,PhD; Michael S. Landau, MD
The patient is a woman in her 70s who was referred to a head and neck surgeon for evaluation of a left thyroid nodule. On ultrasound, the nodule measured 2.3 cm with calcifications. She subsequently underwent fine needle aspiration biopsy and specimens were sent for cytology, the result of which prompted molecular testing on the FNA specimen.
CYTOLOGY (per outside report)
The Papanicolaou stained direct smears were described as showing Hurthle cells characterized by uniform nuclei, prominent nucleoli and abundant granular cytoplasm. (Figure 1) These were dispersed singly and in clusters in a hemorrhagic background. Binucleate forms were also seen.
The cytology diagnosis was "Hurthle cell nodule". ThyroSeq® was performed and showed a RET p.C630R mutation (37% allele frequency) and high calcitonin gene expression.
DIAGNOSIS and DISCUSSION