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Clinical Problem Solving
August 2013

Thyroid Nodule

Author Affiliations
  • 1Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
  • 2Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 3Division of Endocrine Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

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JAMA Otolaryngol Head Neck Surg. 2013;139(8):855-857. doi:10.1001/jamaoto.2013.3816

A 20-year-old, clinically euthyroid African American woman with no significant medical history presented with a 1.4-cm left thyroid nodule. The nodule gradually increased in size and an ultrasonography-guided fine-needle aspiration (FNA) biopsy was performed, which demonstrated large polygonal oncocyte-like cells with abundant granular cytoplasm, ill-defined borders, and small pyknotic nuclei in a background of granular material without colloid. These findings were interpreted as an oncocytic (Hürthle cell) neoplasm or lesion (Figure, A). Molecular testing for BRAF, NRAS61, and KRAS12/13 mutations and RET/PTC1, RET/PTC3, and PAX8/PPAR-gamma translocations were negative.

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