case_images: PMC10665479_01
case_images: Thyroid ultrasonography examination showed a tumor increasing in size over a 19-month period, from 19.7 x 12.9 x 19.4 mm (A) to 22.0 x 12.7 x 27.6 mm at the time of presentation (B). Arrows show the tumor extent. PET-CT showed a tumor with strong FDG accumulation (SUV max: 8.36) (C) and another part of the thyroid with diffuse FDG accumulation (D). Fine needle aspiration cytology showed ground glass nuclei and nuclear pseudoinclusion (intranuclear cytoplasmic inclusion) (E) (Papanicolaou staining. Scale bar is 20 mum). PET, positive emission tomography; CT, computed tomography; FDG, fluorodeoxyglucose; SUV, standardized uptake value.
case_images: fonc-13-1150002-g001.jpg
case_images: PMC10665479_01_fonc-13-1150002-g001.jpg
case_images: f1
case_images: The diameters of the tumor almost did not change, however, at the current presentation, ultrasound showed a tumor increasing in size from 19.7 x 12.9 x 19.4 mm at 19 months previously to 22.0 x 12.7 x 27.6 mm ( Figures 1A, B ). In contrast, the thyroid showed diffuse FDG accumulation, suggesting chronic thyroiditis ( Figures 1C, D ). Because there were not enough cell clusters to make a definitive diagnosis of papillary thyroid carcinoma, the pathologist made a diagnosis of "suspicion of papillary thyroid carcinoma" ( Figure 1E ).
case_images: Histopathological analysis. Hematoxylin and eosin staining (A-E). Papillary thyroid carcinoma on the right side and chronic thyroiditis on the left side (A). Solid and trabecular patterns within the carcinoma (B). The arrowhead shows a nuclear pseudoinclusion (intranuclear cytoplasmic inclusion) (C). Nuclear grooves are slightly conspicuous in carcinoma cells (D). Ground glass nuclei are conspicuous in carcinoma cells and nuclear pseudoinclusions are partly identified (arrowhead) (E). Immunohistochemical analyses show expression of thyroglobulin (F), MIB-1 (MIB-1 labeling index: 5-10%) (G) and P53 (H). Scale bars: 400 mum (A), 100 mum (B) and 20 mum (C-H).
case_images: fonc-13-1150002-g002.jpg
case_images: PMC10665479_01_fonc-13-1150002-g002.jpg
case_images: f2
case_images: Histopathology showed that the tumor consisted of a solid-trabecular structure of multiple vascular and lymphatic invasions with chronic thyroiditis ( Figures 2A, B ). The tumor had the characteristics of PTC with nuclear pseudoinclusion (intranuclear cytoplasmic inclusion) ( Figure 2C ) and nuclear grooves ( Figure 2D ). Ground glass nuclei were conspicuous in carcinoma cells and part nuclear pseudoinclusions were partly identified ( Figure 2E ). Based on immunohistochemical staining, there was a diffuse expression of thyroglobulin in the tumor cells ( Figure 2F ). The tumor cells expressed MIB-1 with a labeling index of 5-10% ( Figure 2G ). P53 was partially expressed in the tumor cells ( Figure 2H ).