case_images: PMC6368986_01
case_images: A,B: Low and high power examination reveal a papillary tumour with fibrovascular cores. The lining cells have overlapping nuclei with grooves and pseudo inclusions. C,D). Lymph node replaced by metastatic papillary thyroid carcinoma (H&E. low and high power magnification)
case_images: ijo-31-069-g002.jpg
case_images: PMC6368986_01_ijo-31-069-g002.jpg
case_images: F2
case_images: The lining cells exhibited enlarged nuclei with focal grooves, pseudo-inclusions and overlapping (Fig.2 A,B). The tumor involved 8/13 neck lymph nodes (Fig.2 C,D), and was staged as pT3, N1.
case_images: A, B: Circumscribed cellular spindle cell tumour arranged in fascicles. The cells have hyperchromatic nuclei. C). Diffuse strong nuclear positivity of TLE1 in tumour cells. D). FISH reveal break-apart signals in tumour cells
case_images: ijo-31-069-g003.jpg
case_images: PMC6368986_01_ijo-31-069-g003.jpg
case_images: F3
case_images: The tumor cells were positive for Cytokeratin (CK) AE1/AE3,epithelial membrane antigen (EMA), Bcl2, CD99 and transducer-like enhancer of split 1(TLE1) (Fig.3C).  Translocation SS18 was detected by fluorescence in situ hybridization (Fig.3D) Final diagnosis was conventional papillary thyroid carcinoma and monophasic synovial sarcoma of the neck.The patient was discharged in the subsequent days after neck drain removal and once stable.