Thyroid gland
Grossing thyroid specimens

Author: Shahidul Islam, M.D., Ph.D. (see Authors page)

Revised: 22 February 2017, last major update March 2009

Copyright: (c) 2003-2017,, Inc.

PubMed Search: histologic sampling thyroid

Cite this page: Grossing thyroid specimens. website. Accessed June 24th, 2018.
Definition / general
  • Describe procedure, how specimen is received (fresh or fixed, intact or fragmented)
  • Recommended to incorporate clinical history of patient into gross examination
  • Weigh and measure thyroid gland
  • Describe size, shape, color, symmetry and consistency of entire specimen, tumor, nodules or other areas
  • Ink if tumor is suspected
  • Describe number, location, encapsulation, secondary changes, distance to surgical margins for nodules
  • Section longitudinally every 5 mm; to detect microcarcinomas, recommended to fix before sectioning
  • Measure maximal tumor size
  • Describe thyroid tissue away from tumor, other attached tissue (if any)
  • Search for parathyroid glands in adipose tissue and describe
  • Dissect lymph nodes and describe

Sections to obtain:
  • For diffuse inflammatory lesions - include 3 sections from each lobe, 1 from isthmus
  • For multinodular goiter, at least one section (firmer areas) from each nodule, plus all scars
  • For encapsulated nodules, submit entire nodule with tumor capsule and normal thyroid, or at least 10 sections
  • For single nonencapsulated tumors larger than 2 cm, submit several sections of tumor, including margins adjacent to normal thyroid, thyroid capsule and isthmus; for smaller tumors, submit entire lesion
  • To confirm papillary thyroid carcinoma diagnosis from FNA, sample surrounding thyroid and margins, check for other lesions
  • For follicular neoplasms, include at least 10 blocks of capsule (tumor, capsule and adjacent normal thyroid); can put multiple pieces in same cassette
Additional references