A 58-Year-Old Man Comes to the Office for Evaluation of a Thyroid

A 58-year-old man comes to the office for evaluation of a thyroid nodule.  The patient first noticed a painless neck lump 2 months ago, which has progressively enlarged.  He has had no heat or cold intolerance, recent weight changes, or difficulty breathing or swallowing.  Medical history is notable for well-controlled hypertension.  The patient has no history of radiation exposure or family history of thyroid diseases.  Physical examination shows a firm, nontender nodule in the right thyroid lobe.  Serum TSH level is normal, and ultrasonography shows a 4-cm solid nodule in the right thyroid lobe.  Fine-needle aspiration biopsy shows a large number of follicular cells dispersed in clusters and microfollicles.  The patient undergoes right thyroid lobectomy.  Which of the following histologic findings would confirm a diagnosis of follicular thyroid carcinoma in this patient?

A) C-cell hyperplasia
B) Cells with empty appearing nuclei
C) Hürthle cells
D) Lymphocytic germinal centers
E) Multinucleated giant cells
F) Tumor capsular invasion

Correct Answer:

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