Macrofollicular variant of follicular thyroid carcinoma: a clinical, cytologic, morphologic, and image analysis study of a unique case

  • Bongiovanni M
  • Gremaud M
  • Moulin C
 et al. 
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Abstract

Thyroid lesions composed of large follicles that contain abundant colloid are usually regarded as benign hyperplastic or adenomatous nodules both by fine-needle aspiration cytology and histology. In such cases, the pathologist is less likely to request a complete inclusion of the capsule into paraffin block and to look for vascular and/or capsular invasion, the only criteria that permit the differential diagnosis between a benign nodule and a follicular carcinoma. We report the first case of a follicular thyroid carcinoma composed predominantly (>90%) of macrofollicles with a surface area that was up to 5 times larger than the surface area of normal follicles, as calculated with an image analysis system. Capsular invasion was detected in 2 separate foci. The tumor was classified as a minimally invasive follicular carcinoma, macrofollicular variant. This case is detailed to highlight the potential pitfall that may arise from an incomplete histological analysis of a macrofollicular lesion, with particular attention paid to the differential diagnoses. © 2009 Elsevier Inc. All rights reserved.

Author-supplied keywords

  • Fine-needle aspiration
  • Follicular thyroid carcinoma
  • Macrofollicular variant

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Authors

  • Massimo Bongiovanni

  • Magali Gremaud

  • Cecile Stephan Moulin

  • Christof Scheidegger

  • Catherine Biton

  • Sophie Clément

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