By Daisy Wu, MD
Clinical History
A female in her 70s presented with acute on chronic hypoxic respiratory failure. Upon workup, she was found to have a TIRADS 5 thyroid isthmus lesion. The clinical team wanted to rule out malignancy prior to tracheostomy placement. The patient underwent an ultrasound-guided fine needle aspiration at an outside institution.
Cytology (Per Outside Report)
This nodule was placed into the Bethesda Category III: Atypia of Undetermined Significance.
The sample was described as hypocellular with poor preservation artifact and demonstrate few groups of highly atypical cells with nuclear enlargement, crowding, elongation, and multiple nuclear pseudoinclusions as well as abundant cytoplasms.
ThyroSeq® was performed and showed a PAX8-GLIS3 fusion.