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liguoxia71 离线
Ok! Basically, the pictures show spindle cells in the thyroid aspirates. I agree that medullary carcinoma is in the differential. When I see spindle cells in thyroid FNA, the first thing you want to ask yourself is : is the spindle cell prolifeartion represent a non-neoplastic or neoplastic process? You can see focal areas of spindle cells proliferation in nodular goiter, granulomatous thyroiditis, post therapy change, or granulation tissue. I have certainly made mistakes and I have seen other pathologists made mistakes on calling some focal reactive spindle cells neoplastic.
On the other hand, if the whole case and every slides show this population of spindle cells, then there is great concern for a neoplastic process, for that, I usually make a cell block to do immunostains.
liguoxia71 离线