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  • Title: Macrofollicular variant of follicular thyroid carcinoma: a clinical, cytologic, morphologic, and image analysis study of a unique case.
    Author: Bongiovanni M, Gremaud M, Moulin CS, Scheidegger C, Biton C, Clément S.
    Journal: Ann Diagn Pathol; 2009 Apr; 13(2):101-5. PubMed ID: 19302958.
    Abstract:
    Thyroid lesions composed of large follicles that contain abundant colloid are usually regarded as benign hyperplastic or adenomatous nodules both by fine-needle aspiration cytology and histology. In such cases, the pathologist is less likely to request a complete inclusion of the capsule into paraffin block and to look for vascular and/or capsular invasion, the only criteria that permit the differential diagnosis between a benign nodule and a follicular carcinoma. We report the first case of a follicular thyroid carcinoma composed predominantly (>90%) of macrofollicles with a surface area that was up to 5 times larger than the surface area of normal follicles, as calculated with an image analysis system. Capsular invasion was detected in 2 separate foci. The tumor was classified as a minimally invasive follicular carcinoma, macrofollicular variant. This case is detailed to highlight the potential pitfall that may arise from an incomplete histological analysis of a macrofollicular lesion, with particular attention paid to the differential diagnoses.
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