Thyrophobia: how to overcome your fear of thyroid follicular tumours

Abstract

Thyroid follicular derived lesions are common in surgical pathology and range from non-neoplastic and inconsequential all the way to rare aggressive tumours. Unfortunately, the histological features can overlap substantially across this spectrum of diagnostic possibilities. The field of thyroid pathology is also notorious for being difficult for the pathologist, with reportedly high inter-observer variability, challenging interpretations of reported criteria, and a lack of good ancillary diagnostic assays. For all these reasons (and more), the pathologist facing a thyroid follicular lesion may have to wade through anxiety-provoking differential diagnoses that impact directly on patient care and follow-up. This course will provide extensive illustrations and images to describe some of the standard and more subtle histological and cytological features of thyroid follicular tumours. The presentation will provide the pathologist with hints and tips for practical use in their every-day sign-out, and will review some of the ancillary testing that has been reported in the literature.