Animated tram truck appearance of papillary thyroid carcinoma, tall cell variant

My profound appreciation for pathology stems from its unparalleled focus on detail within the medical field. The ability to derive a diagnosis from the subtle nuances of a cell's chromatin pattern is, in my view, truly remarkable, that is why I am deeply in love with pathology.

Thanks all for your inputs, indeed it is an incidentally found LCH within a LN, beside Warthin tumor that showed squamous metaplasia (up to 7% of the shows metaplasia), that could be seen post FNA or due to infarction, may be problematic for the pathologist particularly in FNA.

The first two photos are from the parotid nodule and the last two are from the intra parotid LN.

Old age male, smoker, with parotid mass, FNA (Milan IV A, Warthin), intra-parotid LN shows this findings, if you ask for one IHC, what would be?!

RT @pepeheffernan: CC367. EBUS-TBNA of mediastinal nodes in an old woman with an extra pulmonary known tumor. Rhabdoid cells: abundant, den….

If just there were a tall cell subtype of medullary thyroid carcinoma, this would be a one. 👇👇👇.#thyroid

Answer the poll bellow;.How do you report this.

Set3: IHC

Set 2: LNs

#Thyroid.65 F, end stage thyroid with cervical lymphadenopathy, FNA of LN was metastatic PTC, total with LN dissection, no tumor in thyroid found, LNs showed metastatic PTc with squamous dedifferentiaion, PAX8 and TTF1 +ve, WT1 -ve, single psammoma was seen in thyroid.Set 1:

When encountering non-tumor-associated psammoma bodies, a thorough re-examination of the gross is warranted. If no grossly suspicious mass is identified, the entire thyroid should be submitted for examination. Additionally, the case should be discussed with the surgeon.

RT @PoloniaAntonio: F, 40s, breast nodule. @atman_ci @DrGeeONE @fouad_boulos @RazaHoda @ADamronMD @Teclis82 @LizaMQuintana @tlabiano @A_Mor….

Set 3:.CK5/6, p40 in solid area, TTF1 in solid and PTC area respectively

Set 2:

28 F, total thyroidectomy wil LN dissection .PTC-SD.Note the area with solid growth pattern, CK5/6 and p40 are positive in these areas, while TTF1 is negative.#PathTwitter .#Endocrine .Set 1:

Previously added case on parathyroid SETTLE here, is now published in an open access journal .

In my practice, in the above scenario, I will give N1a, but if other LN is involved, then I will ignore the one with psammoma bodies, and will not add it to the numbers of the involved LNs.

Psammoma bodies are not specific for PTC, they could be seen in MTC & oncocytic tumors as well.

A point for discussion .If you have a case of PTC without obvious LVI, and you found few LNs around the thyroid, one of the contains only psammoma bodies withou epithelial component, even in subsequent levels! Do regard it as N1a or N0 and why?