40-year old female presented with neck swelling. Gross and histology is shown below. What is your diagnosis?
High-Yield Explanation
Ref. Robbins Pathology. 9th edition. Page. 1099
Medullary carcinoma thyroid
Gross
Single or multiple
Typically nonencapsulated
Solid, gray / tan / yellow, firm, may be infiltrative
Microscopy
Round, polygonal or spindle cells in nests, cords or follicles, defined by sharply outlined fibrous bands
Tumor cells have granular cytoplasm and uniform round / oval nuclei with punctate chromatin
Stroma has amyloid deposits from calcitonin, prominent vascularity with glomeruloid configuration or long cords of vessels, coarse calcifications
IHC – Calcitonin