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Left Thyroid, FNA: Malignant. (Category VI) Cellular aspirate. Malignant cells present with papillary fragments, powdery chromatin, nuclear grooves, intranuclear cytoplasmic pseudoinclusions, multinucleated giant cells and psammoma bodies consistent with papillary thyroid carcinoma.
Suspicious for malignancy
Left Thyroid, FNA: SUSPICIOUS for papillary thyroid carcinoma, see comment. (Category V) Comment: Cellular aspirate. Follicular cells present in loosely cohesive groups and singly with irregular nuclear membranes, coarse chromatin and nucleoli.
Suspicious for follicular neoplasm. (Category IV) Moderately cellular aspirate. Follicular cells with a predominantly microfollicular and syncytial architecture, scattered isolated cells, and colloid. Correlation of cytological findings with radiological and clinical findings is warranted.
Molecular testing may be considered
The impression on imaging and the ACR TI-RADS are noted. The differential diagnosis includes (benign) adenomatoid nodule, follicular adenoma and follicular carcinoma. Molecular testing (not available in house) would be a fair and reasonable consideration. The cell block has moderate cellularity; it likely has sufficient tissue.
Right Thyroid, FNA: Non-diagnostic. (Category I) Specimen processed and examined, but unsatisfactory due to insufficient material. Mainly blood noted with rare groups of follicular cells. Note: A repeat aspiration should be considered if clinically warranted.
Right Thyroid, FNA: Benign. (Category II) Scant aspirate. Benign-appearing follicular cells, colloid, and occasional Hurthle cells, suggestive of a benign follicular nodule.
Left Thyroid, FNA: Atypia of undetermined significance (AUS). (Category III)