#headandneck #histology #spotter #thyroidpath
#Thyroid swelling, 38 yr female. Total thyroidectomy specimen
What is the lesion and the characteristic?
4
5
35
1,923
Apr 30
#PathQuiz 🔬🦋 #ThyroidPath
A) NIFTP
B) High-grade follicular cell-derived thyroid carcinoma
C) Oncocytic Carcinoma
D) Invasive Encapsulated Follicular Variant of Papillary Thyroid Carcinoma
12%
A
12%
B
4%
C
72%
D
81 votes • Final results
1
2
558
Apr 30
#PathQuiz 🔬🦋 #ThyroidPath
A) NIFTP
B) High-grade follicular cell-derived thyroid carcinoma
C) Oncocytic Carcinoma
D) Invasive Encapsulated Follicular Variant of Papillary Thyroid Carcinoma
#Pathology #ThyroidPath
ALT A 48-year-old woman presents with a solitary, well-demarcated thyroid mass. Capsular invasion. @IARCWHO
ALT Note the unequivocal penetration through the thick fibrous capsule and into adjacent vascular spaces.
1
12
37
2,695
Apr 30
#PathQuiz 🔬🦋 #ThyroidPath
A) NIFTP
B) IEFVPTC
C) Cribriform Morular Thyroid Carcinoma
D) Classic Papillary Thyroid Carcinoma
#Pathology #ThyroidPath
ALT A 45-year-old man presents with a solitary, 2.5 cm, well-demarcated thyroid nodule. Encapsulated neoplasm showing a predominantly follicular growth pattern. @IARCWHO
1
14
39
3,446
Apr 28
#PathQuiz 🔬🦋 #ThyroidPath
A) Mucoepidermoid carcinoma
B) Medullary thyroid carcinoma
C) Oncocytic carcinoma
D) Secretory carcinoma
#Pathology #ThyroidPath
3
7
30
2,286
Apr 28
#PathQuiz 🔬🦋 #ThyroidPath
A) Oncocytic adenoma
B) Follicular adenoma
C) Medullary thyroid carcinoma
D) Oncocytic carcinoma
#Pathology #ThyroidPath
1
5
10
1,023
Apr 28
#PathQuiz 🔬🦋 #ThyroidPath
A) Papillary thyroid carcinoma
B) Medullary thyroid carcinoma
C) Cribriform morular thyroid carcinoma
D) Hyalinizing trabecular tumor
2%
A
5%
B
6%
C
87%
D
86 votes • Final results
1
1
3
795
Apr 28
#PathQuiz 🔬🦋 #ThyroidPath
A) Papillary thyroid carcinoma
B) Medullary thyroid carcinoma
C) Cribriform morular thyroid carcinoma
D) Hyalinizing trabecular tumor
#Pathology #ThyroidPath
2
16
42
2,869
❄️ Frozen to Final: Diagnostic Correlation
Case: 75M with massive compressive thyroid mass (9 cm) with tracheal invasion
🧊 Frozen: Malignant tumor (subtype deferred)
💎 Final diagnosis: Medullary Thyroid Carcinoma
🔬 Key features:
• Nests, trabeculae, cords
• Polygonal cells, granular cytoplasm
• Salt & pepper chromatin
• Lymphovascular invasion
🧪 IHC:
Calcitonin , CEA , Synapto , Chromogranin , INSM1
CK7 , CK20-, TTF1 (diffuse)
Thyroglobulin–, PAX8–
🧬 Molecular:
• Activating RET mutations in majority (germline in hereditary cases – MEN2A/MEN2B; somatic in sporadic)
• RAS mutations (HRAS/KRAS) in RET–negative tumors
• Routine: recommend RET mutation testing ± germline screening (important for family counseling)
📊 Prognosis:
• Variable; worse with: Older age, large tumor, extrathyroidal extension (like tracheal invasion here) and distant metastasis
• 10-year survival ~70–80% overall, but ↓ significantly in advanced disease
• Calcitonin doubling time = key prognostic marker
💡 Pearl:
When morphology & clinical picture mismatch on frozen → call “malignant” & defer typing.
IHC serum calcitonin clinches MTC.
#PathTwitter #Surgpath #EndocrinePath #ThyroidPath #MedullaryThyroidCarcinoma #FrozenSection #Histopathology #Pathology
Case courtesy @annsmiley78
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10
34
1,676
❄️ FROZEN SECTION.
👉 75 YO male with massive thyroid mass (9 × 6 cm) replacing the left lobe, with tracheal invasion and loss of fat plane with esophagus.
Intraoperative frozen section performed.
Diagnosis?
#PathTwitter #SurgPath #ThyroidPath #FrozenSection
#DiagnosticDilemma #Histopathology #OncPath #MedEd
Case courtesy @annsmiley78
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13
37
2,708
Apr 5
#PathQuiz 🔬🦋 #EndoPath
A) Secretory carcinoma
B) Hyalinizing trabecular tumor
C) Papillary thyroid carcinoma
D) Cribriform morular thyroid carcinoma
#Pathology #ThyroidPath Clue in caption 🧐
ALT A 28-year-old woman presents with a well-circumscribed thyroid mass showing an admixture of cribriform and squamoid morular patterns. Morule and cribriform tubular growth patterns without intervening fibrous stroma @IARCWHO
2
16
43
3,978
Congratulations to a rising phenom, Dr. Qi Yu Tan (PGY-1), for her poster presentation on the clinicopathologic features of oncocytic #thyroidpath neoplasms. Way to represent - your @BrownPathology colleagues are so proud of your accomplishments!
1
15
1,138
Frozen section challenge:
• 2-cm well-circumscribed tan thyroid nodule
• Diff-Quik: plasmacytoid cells in a bloody background
What’s your diagnosis at the #FrozenSection bench?
IHC result below 👇
#cytopath #thyroidpath #pathology
4
8
47
3,268
Jan 1
Metastatic medullary thyroid carcinoma to spine and pelvis.
#ENTPath #EndoPath #ThyroidPath #HeadandNeckPath
Upon detailed questioning, the patient reported a history of thyroidectomy 10 years ago; however, no medical records are available for verification.
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733
4 Sep 2025
It's September, and Tumors of the Thyroid and Parathyroid Glands (arppress.org/books/book/68) has joined our series 5 fascicles!
Solid cell nests are remnants of the ultimobranchial bodies and are found in 3% of routinely examined thyroid glands. They often have a squamoid appearance.
#HNpath #ENTpath #ThyroidPath
ALT SOLID CELL NEST (SCN): At low power, this insignificant vestigial structure has a stellate appearance and can be misinterpreted as a papillary microcarcinoma.
ALT SOLID CELL NEST: The main cells of this embryonal remnant have a squamoid appearance with nuclear grooves. The latter can lead to an incorrect diagnosis of papillary microcarcinoma.
1
14
40
2,349
21 Aug 2025
A wonderful set of authors from @MGBpathology @MSKPathology & #TheOldCountry 🇮🇹! #EndoPath #ThyroidPath @AmThyroidAssn @BinXu16
21 Aug 2025
TUMORS OF THE THYROID AND PARATHYROID GLANDS (Series 5, vol 23 of AFIP atlases) is published! Congratulations to Ronald Ghossein, Bin Xu, Justine Barletta, and Giovanni Tallini on this beautiful atlas! It was an honor to serve as your editor! #PathX #Pathtwitter @MGBPathology @ARP_Press
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52
2,226
20 Feb 2025
61-year-old cisgender man with a thyroid mass. CT scan showed lesions suspicious for metastasis to bone, liver, and lymph nodes. Fine needle biopsy. #thyroidpath
1
2
12
930
21 Jul 2024
Currently strugling with this case, would appreciate your opinioins.
F, 30 y.o., thyroid nodule 0.6 cm.
With a history of previous FNA, would you call this capsular invasion or not?
#PathTwitter #EndoPath #thyroidpath #endopath
6
2
7
1,103
17 Jun 2024
Three in one! Neck LN dissection:
1. Metastatic melanoma c/w known hx
2. New met papillary thyroid carcinoma, IHC BRAF
3. New CLL/SLL
#PathTwitter #HemePath #ThyroidPath #ENTPath #headandneckpath #DermPath #SurgPath #MedTwitter
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686