December 2010

Manon Auger, MD, FRCP(C), MIAC
Director, Cytopathology Laboratory, McGill University Health Center
Associate Professor, Department of Pathology, McGill University
Montreal, PQ, Canada

Fine needle aspirate of a 2 cm nodule in the right lobe of the thyroid in a 69 year old woman. 

Cytomorphology of the case:  (Fig.1-9)
The smears are very cellular consisting of a monotonous population of Hurthle cells characterized by abundant granular cytoplasm, a round eccentrically located nucleus, and a prominent nucleolus. The Hurthle cells are arranged predominantly in a syncytial or trabecular arrangement; many single Hurthle cells are also noted. Some of the cells are seen in close connection to capillaries (Fig.5). Macrophages, indicative of cystic degeneration, are seen in the background.

fig 1 dec 2010 1-Diff-Quik stain, 200X
fig 2 dec 2010 2-Diff-Quik stain, 400X
fig 3 dec 2010 3- Papanicolaou stain, 200X
fig 4 dec 2010 4-Papanicolaou stain, 200X
fig 5 dec 2010 5-Papanicolaou stain, 200X
fig 6 dec 2010 6-Papanicolaou stain, 400X
fig 7 dec 2010 7-Papanicolaou stain, 400X
fig 8 dec 2010 8-Papanicolaou stain, 600X
fig 9 dec 2010 9-Papanicolaou stain, 600X

Your diagnosis?