Relationship of step section and accuracy of pathologic diagnosis of thyroid cancers

Abstract

Objective: This case history shows the significance of the step section to be performed on any extra thyroidal neck mass containing thyroid tissue. The material for pathologic diagnosis was a neck mass removed from the left tracheoesophageal groove in a 43-year-old lady whose right hemithyroidectomy was performed by the authors fourteen years ago (Mrs.D.).Her previous pathologic report was follicular adenoma. The report on her new pathologic specimen was" benign thyroid tissue." However, this report did not match her previous medical history, and we requested a step section (extensive levelling) to be performed on the specimen. Her final pathologic diagnosis was "near-total replacement of a lymph node by well- differentiated thyroid carcinoma." She underwent a total thyroidectomy and central neck dissection, followed by our nuclear medicine team for seven years.