CASE N°08 – Thyroid carcinoma mimicking adenoid cystic carcinoma

Clinical History:

Age: 79

Sex:  female

Endocrinology examination:
multinodular thyroid gland. In the past she underwent therapy with 131-I for hyperthyroidism. Conclusions: multinodular goiter

Cytological Images:

Cytological material: Thyroid FNA

Cytological Report:

Positive for malignant cells.

After cytological diagnosis she underwent CAT (computerized axial tomography):

Both lungs with many and diffuse nodular lesions of pathological meaning. Numerous adenopathy at the level of the main mediastinal stations.          Hepatic parenchyma with focal lesion, 1 cm in diameter, of pathological meaning.

Histological Images:

Hystological material: Thyroidectomy

 Thyreoglobulin

 Alcian-PAS

Histological Report:

Poorly differentiated thyroid carcinoma.

Discussion:

Spherical hyaline globules are characteristic finding in Salivary Gland Tumors but are rare in thyroid tumors:  few cases are reported in literature with this pattern in thyroid pathology.

Poorly differentiated thyroid carcinoma may present with multiple cytological picture (hyaline globules included); we must keep in mind this aspect, with the scope not to commit erroneous diagnoses. Immunohistochemically  the tumor cell were positive for Thyroglobulin. Also take a look to the Alcian-PAS stain.

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