Question:medium
A 25-year-old male presented with a 2 cm thyroid nodule. A thyroidectomy was done and the histology is shown below. What could be the diagnosis?
A 25-year-old male presented with a 2 cm thyroid nodule. A thyroidectomy was done and the histology is shown below. What could be the diagnosis?
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The nuclear features, clear chromatin and psammoma bodies, clinch this thyroid malignancy.
Updated On: Jun 23, 2026
- Papillary carcinoma thyroid
- Follicular adenoma
- Graves disease
- Adenomatous goitre
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The Correct Option is A
Solution and Explanation
Nuclei tell the story: papillary thyroid carcinoma is a diagnosis made on nuclear morphology, not architecture. The slide shows Orphan Annie eye nuclei (empty, ground glass chromatin), nuclear grooves and pseudoinclusions, with psammoma bodies in true fibrovascular-cored papillae. That combination is pathognomonic for papillary carcinoma.
Distinguish the mimics. Graves disease also forms papillae, but they are hyperplastic, lack fibrovascular cores and the nuclei are normal. Follicular adenoma is a solitary encapsulated follicular proliferation without papillae or clear nuclei. Adenomatous goitre is a multinodular colloid-rich lesion. None reproduces the optically clear nuclei and psammoma bodies, so the answer is papillary carcinoma of the thyroid, which characteristically spreads via lymphatics.
Ref: Robbins Basic Pathology, 9th edition, pg 736.
Distinguish the mimics. Graves disease also forms papillae, but they are hyperplastic, lack fibrovascular cores and the nuclei are normal. Follicular adenoma is a solitary encapsulated follicular proliferation without papillae or clear nuclei. Adenomatous goitre is a multinodular colloid-rich lesion. None reproduces the optically clear nuclei and psammoma bodies, so the answer is papillary carcinoma of the thyroid, which characteristically spreads via lymphatics.
Ref: Robbins Basic Pathology, 9th edition, pg 736.
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