- The organ has a smooth surface with a
mild degree of lobulation. The normal tissue has a spongy nature to it
and so this is the thyroid gland.
- There is a single nodule present
measuring 3cm by 1.5cm. It is a solid nodule with areas of haemorrhage.
It has a thin white to grey capsule and there appears to be compression
of the adjacent gland.
- The lesion is a neoplasm and because
it is encapsulated it is most likely to be a follicular neoplasm. As
invasion of the capsule or vascular invasion may only be detected
microscopically, the distinction between an adenoma and a carcinoma can
not be made at this time.
- The main differential diagnosis is
that of a hyperplastic nodule. This lesion tends not to be encapsulated,
does not normally compress the adjacent thyroid and microscopically has
a similar histology to that of the adjacent thyroid. The histology of
this nodule confirmed the presence of a follicular adenoma but was an
unusual one in that the tumour cells were large and had abundant
eosinophilic granular cytoplasm. This variant is called a Hurthle cell
- The sudden development of a nodule in
the neck is due to haemorrhage into the tumour.