CASE 1: FNA OF A LARGE GOITRE

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CASE 1 FNA OF A LARGE GOITRE

• Roberto Dina, MD
• Cytology
• Dept of Histopathology
• Hammersmith Hospital
• London (U.K.)

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CASE HISTORY

• A 77 yr old Female with a history of long
  standing goitre
• Presents with a recently enlarged thyroid
• Smoker

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Imaging

• Large heterogeneous mass within the neck
  consistent with the patients goitre. The trachea
  is markedly deviated to the right and narrowed in
  the coronal dimension to 6 mm. The goitre extends
  to the superior aspect of the sternum. Within the
  anterior segment of the LUL there is a spiculated
  11 mm diameter nodule which appears to be
  cavitating anteriorly.

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Bronchoscopy

• Bronchoscopy normal
• Bronchial washing and brushing Negative for
  malignant cells

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FNA PERFORMED

• 4 Passes (27 G needle)
• Scanty Material

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Isolated atypical nuclei
lymphocytes
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CYTOLOGY

• Necrotic Background
• Multinucleated Giant Cells
• Histiocyte like cells
• Atypical Cells
• Aggregates of Lymphocytes