Abstract
We report a case of a 58-year-old Caucasian woman affected by papillary thyroid microcarcinoma (PTMC) of the left-lobe of the gland with very small size (Ø 0.3 cm). The characteristics with the Diagnostic Imaging using Ultrasonography, ADF (Advanced Dynamic Flow), and fine-needle-aspiration cytology (FNAC) are discussed, comprising a very small micro-focus of radial shape, with markedly hypoechoic echostructure, irregular margins, supplemented by peripheral vessel formation. It acquires an image which appears similar to a brisk visualization of a dark ink stain in the normal thyroid weave. We call such a pattern “Black Ink” with ultrasonographic image and believe consistent with the infiltrating variant of papillary thyroid microcarcinoma if associated with malignant cytology after FNA.
Highlights
According to WHO Papillary Microcarcinoma is any thyroid papillary carcinoma with a diameter of 1 cm or less [1]
We report a case of a 58-year-old Caucasian woman affected by papillary thyroid microcarcinoma (PTMC) of the left-lobe of the gland with very small size (Ø 0.3 cm)
We present a case of a infiltrating papillary thyroid microcarcinoma, size 0.3 cm, identified on the ultrasound examination and ADF in the left of the thyroid lobe
Summary
According to WHO Papillary Microcarcinoma is any thyroid papillary carcinoma with a diameter of 1 cm or less [1]. We present a case of a infiltrating papillary thyroid microcarcinoma, size 0.3 cm, identified on the ultrasound examination and ADF in the left of the thyroid lobe. Cytologic examination of the slides (Papanicolaou stain) allowed recognition of malignancy with cytologic pattern very suspicious for papillary tumor (TIR5 cathegory according to Italian Consensus, cathegory VI according to The Bethesda System for Reporting Thyroid Cytopathology (Figure 9, 10). Histological examination of the lesion showed a proliferation of well differentiated epithelial cells forming an purely papillary structure surrounded by blood vessels, with irregular borders, overtly infiltranting thyroid parenchyma. White arrow highliths a papillary group of neoplastic cells penetrating normal thyroid follicoles at the periphery of the main focus, which indicates that the tumor already shows tendency to spread in the surrounding (invasion). Post operative remnants therapy with Radioiodine I-131 (RAI), was not administered inasmuch the tumor was very little, contained in the thyroid and lacked vascular invasion
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