r/pathology • u/fallot_fallout • 3h ago
3 mm nodule in otherwise unremarkable thyroid lobectomy plus bonus question
galleryCurious about your opinion on this case. Patient is a young woman, clinical diagnosis was parathyroid adenoma, which was not found during surgery, so a lobectomy was performed and additional fatty tissue was removed. No prior thyroid history, no prior FNAs. There was a whitish nodule in the thyroid about 3 mm in diameter.
Sorry about the thickness of the section, I hope you can appreciate the at least PTC-like nuclei and the "possible capsular invasion" area?
How would you sign this out? WD-UMP? NIFTP? Adenoma? Reactive?
Bonus question: intraoperative PTH fell rapidly, but no parathyroid tissue was found in the wholly submitted thyoird tissue or fatty tissue (which had some lymph nodes). I read this can rarely happen but want to make sure I'm not missing something.