Case 1 Prof. Dr. med. Aurel PERREN Institute of Pathology University of Bern [email protected] www.pathology.unibe.ch Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Clinical information 35 year old male 6cm nodule of the right thyroid Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Macroscopy 6cm nodule of the right thyroid, encapsulated Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Encapsulated neoplasm Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland «normal» nuclei Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Angio-invasion Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Covered by endothelium Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Diagnosis Encapsulated follicluar thyroid carcinoma with minimal vascular invasion 1 vessel invasion in 10 blocks Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Follicular nodules Hyperplastic nodule Follicular adenoma + Follikular Carcinoma + Adenoma minimally invasive FTC Invasion widely invasive FTC Poorly differentiated CA capsule vessel Adenoma Minimally invasive FTC widely invasive FTC Poorly differentiated 100% FTC capsular invasion only 100% FTC limited (<=3) vascular invasion 95% FTC extensive (>3) vascular invasion 85% 40% Capsular invasion only Encapsulated FTC with minimal vascular invasion (<=3) extensive vascular invasion (>3) (widely invasive) Widely invasive FTC Poorly differentiated Carcinoma (>10%) Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Adenoma 100% FT-UMP Minimally invasive FTC widely invasive FTC Poorly differentiated FTC capsular invasion only 100% FTC limited (<=3) vascular invasion 95% FTC extensive (>3) vascular invasion 85% 40% Follicular carcinoma Uncertain capsular or vascular invasion Follicular tumor of uncertain malignant potential FT-UMP Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland Follicular carcinoma Questions? Prof. Dr. med. P. Komminoth STZH Zürich, Switzerland Prof. Dr. med. A. Perren Uni Bern, Switzerland
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