Qap (Anatomical Pathology) 

QAP Peer Review

AP253
Case History: F/46 Right lobe of thyroid
Intended diagnosis: Psammoma bodies in thyroid. Contributed by:PKH
Code Diagnosis Comment Score
anonymous Suspicious of papillary thyroid carcinoma; hyperplastic nodule; parathyroid gland present. (100%) suggest to sample more blocks  100
anonymous Nodular goiter nil  50
anonymous Nodular hyperplasia; intrathyroidal parathyroid tissue featuring hyperplastic changes; calcified psammoma particles present in thyroid tissue. Need to check serum calcium level to rule out hyperparathyroidism. Need to rule out papillary thyroid carcinoma by thorough sampling.  100
anonymous Intra-thyroid parathyroid; colloid nodule. Psammoma bodies seen, further specimen sampling to look for papillary carcinoma.  100
anonymous A background of NODULAR GOITER with psammoma bodies and a focus suspicious of papillary carcinoma (microcarcinoma). Parathyroid gland attached. 100% More sampling to look for more classic groundglass nuclei and nuclear pseudoinclusions.  100
anonymous Follicular lesion with atypia. Please see comment.(100%) DDx between nodular hyperplasia and papillary carcinoma. Do CK19, CD56 and p63 stains. Papillary carcinoma will be CK19+, CD56- and p63+.  100
anonymous Right lobe THYROID - NO MALIGNANCY, presence of psammoma bodies and an intrathyroid parathyroid gland 100% Thorough sampling of the specimen required to exclude existence of papillary thyroid carcinoma.  100
anonymous Colloid nodule, intrathyroidal parathyroid and calcifications nil  80
anonymous Nodular goitre (100%). In view of the presence of psammoma bodies, more extensive sampling should be performed to look for foci of papillary thyroid carcinoma.  100
anonymous Sequestered / Parasitic thyroid nodule; Intrathyroidal parathyroid gland. Because of presence of numerous psammoma bodies, papillary carcinoma should be excluded in other sections in extensive sampling.  100
anonymous Thyroid - Papillary carcinoma must be excluded by deeper sections or additional blocks. nil  100
anonymous Intrathyroidal psammoma bodies, and hyperplastic nodule with focally atypia. There is no indisputable evidence for papillary carcinoma (PTC). Need to totally embed the specimen to exclude PTC.  100
anonymous Thyroid - Hyperplastic nodule; intrathyroidal parathyroid; multiple psammoma body-like calcifications in the thyroid parenchyma, uncertain significance (100%) Further sampling to exclude papillary carcinoma elsewhere.  100
anonymous Follicular lesion with sclerosis (?FNA effect) and mild nuclear atypia not diagnostic of papillary carcinoma, background with many psammoma bodies (100% probability). More sections for any papillary carcinoma suggested.  100
anonymous Intrathyroid parathyroid hyperplasia, 100% nil  50
anonymous Thyroid - Nodular goiter nil  50