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Thyroid gland
Cytology - cytodiagnostic groups

Reviewer: Shahidul Islam, M.D., Ph.D. (see Reviewers page)
Revised: 30 March 2013, last major update March 2009
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

  1. Benign colloid nodule (solitary colloid nodule, prominent nodule in multinodular goiter, macrofollicular adenoma)
  2. Cellular microfollicular lesion (microfollicular adenoma, hyperplastic microfollicular lesion in Hashimoto’s or multinodular goiter, low grade / well differentiated follicular carcinoma)
  3. Hürthle cell lesion (adenoma, carcinoma or hyperplastic nodule in Hashimoto’s or multinodular goiter)
  4. Primary malignant tumor (papillary, high grade microfollicular, insular, medullary or anaplastic carcinoma; lymphoma)
  5. Cystic lesion (benign colloid nodule, papillary carcinoma, other thyroid neoplasm)
  6. Thyroiditis (acute, Hashimoto’s, subacute)
  7. Other (Graves’ disease, metastatic carcinoma)
  8. Nondiagnostic (malignant disease present in 14% with repeat FNA, Am J Surg 2008;196:398)
Probably benign:
Suspicious for malignancy (recommend excision):
Follicular neoplasm:
Follicular neoplasm with features suspicious for papillary carcinoma:
Cytodiagnostic groups with common nodular lesions
Case reports
Cytology images
Benign thyroid follicle
Watery colloid
Indeterminate FNA
Different grades of lesions
Benign colloid nodule:
Thick, deep blue colloid with cracking
Thick, deep blue colloid with bubble pattern
Sheet of benign follicular epithelial cells
Benign epithelial cells, colloid, macrophages
Thin Prep versus pap stain
Hyperplastic thyroid nodule
Hemorrhagic cyst
Cellular microfollicular lesion:
Cells with round nuclei in acini and monolayered sheet
Cells with round nuclei arranged in acini
Solid cellular nodule, microfollicular lesion
Hürthle cell lesion:
Hürthle cells
Hürthle cells in loose monolayered sheets
Hurthle cell adenoma (pap)
Hürthle cell adenoma-Diff-Quik
Hurthle cell adenoma (pap)
Follicular neoplasms:
FNA: follicular neoplasm, excision: follicular adenoma
FNA: suspicious for papillary carcinoma, excision: follicular variant of papillary carcinoma
Epithelial cells in follicular arrangement suggesting adenoma, but which could be from a follicular carcinoma
Follicular neoplasm has enlarged follicular cells in loosely cohesive follicles plus isolated, intact cells (Romanowsky stain)
Suspicious for papillary carcinoma:
Cellular with papillary formation, nuclear inclusions & grooves
Rare intranuclear inclusions and abundant colloid
End of Thyroid gland > General > Cytology - cytodiagnostic groups

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