{"id":45808,"date":"2025-11-17T19:19:12","date_gmt":"2025-11-17T11:19:12","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=45808"},"modified":"2026-03-16T10:26:17","modified_gmt":"2026-03-16T02:26:17","slug":"fna-thyroid","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/","title":{"rendered":"Picture Atlas &#8211; FNA: Thyroid"},"content":{"rendered":"\n<h2>\n\t\tpicture atlas\n\t<\/h2>\n<h2>\n\t\tFINE NEEDLE ASPIRATION: THYROID\n\t<\/h2>\n\t<p>Here are some examples of classical conditions, organised according to categories in The Bethesda System for Reporting Thyroid Cytopathology.<\/p>\n<p>Click on the specific condition to view pic:<\/p>\n<h3><strong>Bethesda Category: Classical cases<\/strong><\/h3>\n<ul>\n<li>\n<h4>Benign<strong><br \/>\n<\/strong><\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#colloid\">Colloid Nodule<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#subacute\">Subacute (de Quervain) Thyroiditis<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#Lymphocytic\">Lymphocytic Thyroiditis<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<h4>Atypical<\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#atypical\">Follicular Lesion of Undetermined Significance \/ Atypia of Undetermined Significance<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<h4>Follicular Neoplasm<\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#FN\">Follicular Neoplasm<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<h4>Malignant<\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#PTC\">Papillary Thyroid Carcinoma<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#MTC\">Medullary Thyroid Carcinoma<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/#ATC\">Anaplastic Thyroid Carcinoma<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>\n\t\tbenign\n\t<\/h3>\n<h4>\n\t\tcase 1\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-1.1.jpg\" alt=\"Benign case 1.1\" itemprop=\"image\" height=\"965\" width=\"1758\" title=\"Benign case 1.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-1.2.jpg\" alt=\"Benign case 1.2\" itemprop=\"image\" height=\"678\" width=\"1204\" title=\"Benign case 1.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-1.3.jpg\" alt=\"Benign case 1.3\" itemprop=\"image\" height=\"687\" width=\"1245\" title=\"Benign case 1.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Colloid nodule<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-1.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-1.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-1.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<ul>\n<li>Flat honeycomb sheets of follicular cells which are evenly spaced showing uniform round nuclei with granular chromatin and scant cytoplasm.<\/li>\n<li>Colloid can appear in the form of a thin, translucent film with bubbles and linear cracks or in the form of thicker blobs.<\/li>\n<li>Macrophages are sometimes present, and, if abundant or accompanied by granular proteinaceous material, indicate cystic change.<\/li>\n<\/ul>\n<h4>\n\t\tcase 2\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.1.jpg\" alt=\"Benign case 2.1\" itemprop=\"image\" height=\"436\" width=\"1024\" title=\"Benign case 2.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.2.jpg\" alt=\"Benign case 2.2\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Benign case 2.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.3.jpg\" alt=\"Benign case 2.3\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Benign case 2.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.4.jpg\" alt=\"Benign case 2.4\" itemprop=\"image\" height=\"596\" width=\"1024\" title=\"Benign case 2.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.5.jpg\" alt=\"Benign case 2.5\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"Benign case 2.5\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Subacute (de Quervain) Thyroiditis<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.1.1.jpg\" alt=\"\" width=\"1487\" height=\"635\" \/><\/td>\n<\/tr>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.2.1.jpg\" alt=\"\" width=\"1488\" height=\"823\" \/><\/td>\n<\/tr>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.3.1.jpg\" alt=\"\" width=\"1482\" height=\"819\" \/><\/td>\n<\/tr>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.4.1.jpg\" alt=\"\" width=\"1488\" height=\"866\" \/><\/td>\n<\/tr>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-2.5.1.jpg\" alt=\"\" width=\"1472\" height=\"828\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n<ul>\n<li>In addition to follicular cells, there are histiocytes, with varying numbers of lymphocytes and\/or some neutrophils.<\/li>\n<li>May have poorly formed epithelioid granulomas.<\/li>\n<li>Presence of large multinucleated giant cells containing numerous nuclei is a helpful feature (sometimes these cells engulf colloid).<\/li>\n<li>Note: Smaller multinucleated giant cells are less specific and may be seen in Hashimoto thyroiditis and papillary thyroid carcinoma.<\/li>\n<\/ul>\n<h4>\n\t\tcase 3\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-3.1.jpg\" alt=\"Benign case 3.1\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Benign case 3.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-3.2.jpg\" alt=\"Benign case 3.2\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Benign case 3.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Lymphocytic Thyroiditis<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-3.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Benign-case-3.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n<ul>\n<li>Benign groups of follicular cells and scant colloid.<\/li>\n<li>Follicular cells may show varying proportions of Hurthle cells with round nuclei and abundant granular cytoplasm.<\/li>\n<li>Many lymphocytes in the background &#8211; mixed population, predominantly small lymphocytes.<\/li>\n<li>Sometimes germinal centre material may be seen. Sometimes multinucleated giant cells are also seen.<\/li>\n<\/ul>\n<h3>\n\t\tatypical\n\t<\/h3>\n<h4>\n\t\tcase 4\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-4.1.jpg\" alt=\"Atypical case 4.1\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Atypical case 4.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-4.2.jpg\" alt=\"Atypical case 4.2\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Atypical case 4.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-4.3.jpg\" alt=\"Atypical case 4.3\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Atypical case 4.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Atypical; Follicular Lesion of Undetermined Significance \/ Atypia of Undetermined Significance<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-4.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-4.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-4.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n<ul>\n<li>The FLUS category is a mixed one, covering a spectrum of findings.<\/li>\n<li>There is architectural and\/or nuclear atypia; but not to the extent of being suspicious for malignancy.<\/li>\n<li>This is an example of FLUS\/AUS with architectural atypia:\n<ul>\n<li>In some areas, the follicular cells show architectural atypia e.g. microfollicles, crowded sheets; while in other areas, some flat sheets are seen.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4>\n\t\tcase 5\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.1.jpg\" alt=\"Atypical case 5.1\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Atypical case 5.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.2.jpg\" alt=\"Atypical case 5.2\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Atypical case 5.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.3.jpg\" alt=\"Atypical case 5.3\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"Atypical case 5.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.4.jpg\" alt=\"Atypical case 5.4\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"Atypical case 5.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Atypical; Follicular Lesion of Undetermined Significance \/ Atypia of Undetermined Significance<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Atypical-case-5.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n<ul>\n<li>The FLUS category is a mixed one, covering a spectrum of findings.<\/li>\n<li>There is architectural and\/or nuclear atypia; but not to the extent of being suspicious for malignancy.<\/li>\n<li>This is an example of FLUS\/AUS with both architectural and nuclear atypia:\n<ul>\n<li>There are crowded sheets of follicular cells arranged in trabecular formations.<\/li>\n<li>Nuclear atypia is seen, with enlarged nuclei with occasional nuclear grooves and rare nuclear pseudoinclusions.<\/li>\n<li>There are insufficient definitive diagnostic features for papillary thyroid carcinoma.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>\n\t\tfollicular neoplasm\n\t<\/h3>\n<h4>\n\t\tcase 6\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.1.jpg\" alt=\"FN case 6.1\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"FN case 6.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.2.jpg\" alt=\"FN case 6.2\" itemprop=\"image\" height=\"615\" width=\"1024\" title=\"FN case 6.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.3.jpg\" alt=\"FN case 6.3\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"FN case 6.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.40.jpg\" alt=\"FN case 6.4(0)\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"FN case 6.4(0)\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.5.jpg\" alt=\"FN case 6.5\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"FN case 6.5\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Follicular Neoplasm<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/FN-case-6.5.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<ul>\n<li>Crowded sheets, microfollicles or trabecular arrangements.<\/li>\n<li>Follicular cells contain round nuclei and with granular chromatin and inconspicuous nucleoli.<\/li>\n<\/ul>\n<h3>\n\t\tmalignant\n\t<\/h3>\n<h4>\n\t\tcase 7\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.1.jpg\" alt=\"PTC case 7.1\" itemprop=\"image\" height=\"1061\" width=\"1920\" title=\"PTC case 7.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.2.jpg\" alt=\"PTC case 7.2\" itemprop=\"image\" height=\"1061\" width=\"1920\" title=\"PTC case 7.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.3.jpg\" alt=\"PTC case 7.3\" itemprop=\"image\" height=\"587\" width=\"1024\" title=\"PTC case 7.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.4.jpg\" alt=\"PTC case 7.4\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"PTC case 7.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Malignant; Papillary Thyroid Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PTC-case-7.4.1-1536x864.jpg\" alt=\"\" width=\"1019\" height=\"573\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n<ul>\n<li>Usually highly cellular aspirates, showing many monolayered syncytial sheets and sometimes papillary structures.<\/li>\n<li>Nuclei overlap each other within the syncytial sheets.<\/li>\n<li>Nuclei are often ovoid and enlarged, with fine powdery chromatin, occasional nuclear grooves and nuclear pseudoinclusions.<\/li>\n<li>Cytoplasm may be delicate or dense.<\/li>\n<li>Thick colloid (&#8220;bubble-gum&#8221; colloid), which are better appreciated in Romanowsky stains, may be present.<\/li>\n<li>Multinucleated giant cells may be noted in the background.<\/li>\n<li>Sometimes, psammoma bodies may be seen, especially in cystic PTC.<\/li>\n<\/ul>\n<h4>\n\t\tcase 8\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.1.jpg\" alt=\"MTC case 8.1\" itemprop=\"image\" height=\"593\" width=\"1024\" title=\"MTC case 8.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.2.jpg\" alt=\"MTC case 8.2\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"MTC case 8.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.3.jpg\" alt=\"MTC case 8.3\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"MTC case 8.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.4.jpg\" alt=\"MTC case 8.4\" itemprop=\"image\" height=\"559\" width=\"1024\" title=\"MTC case 8.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.5.jpg\" alt=\"MTC case 8.5\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"MTC case 8.5\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.6.jpg\" alt=\"MTC case 8.6\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"MTC case 8.6\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Malignant; Medullary Thyroid Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.5.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.6.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MTC-case-8.6.2.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n<ul>\n<li>Cellular aspirates usually.<\/li>\n<li>Loose cell clusters and singly occurring cells.<\/li>\n<li>Cells appear epithelioid\/plasmacytoid or spindled.<\/li>\n<li>Some binucleated or multinucleated cells may be present.<\/li>\n<li>Nuclei have &#8216;salt-and-pepper&#8217; chromatin and inconspicuous nucleoli.<\/li>\n<li>Occasional nuclear inclusions may be seen.<\/li>\n<li>Sometimes, background amyloid may be identified.<\/li>\n<\/ul>\n<h4>\n\t\tcase 9\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ATC-Case-9.1.jpg\" alt=\"ATC Case 9.1\" itemprop=\"image\" height=\"590\" width=\"1024\" title=\"ATC Case 9.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ATC-Case-9.2.jpg\" alt=\"ATC Case 9.2\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"ATC Case 9.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ATC-Case-9.3.jpg\" alt=\"ATC Case 9.3\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"ATC Case 9.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Malignant; Anaplastic Thyroid Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ATC-Case-9.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ATC-Case-9.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ATC-Case-9.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n<ul>\n<li>Markedly pleomorphic nuclei; sometimes spindle cells (sarcomatoid appearance) and squamoid cells.<\/li>\n<li>Necrosis and inflammatory cells may be seen in the background.<\/li>\n<\/ul>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tCytopathology Home\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/quick-approaches\/%20\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tQuick Approaches\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tMystery cases\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tPicture Atlas\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tSSC Cytoquiz\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/www.youtube.com\/playlist?list=PL2TaQ3CT3zlCdQ4ntNg3pE93krOQSrBGt\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tTalking cases\n\t\t\t\t\t<\/a>\n\n","protected":false},"excerpt":{"rendered":"<p>picture atlas FINE NEEDLE ASPIRATION: THYROID Here are some examples of classical conditions, organised according to categories in The Bethesda System for Reporting Thyroid Cytopathology. Click on the specific condition to view pic: Bethesda Category: Classical cases Benign Colloid Nodule Subacute (de Quervain) Thyroiditis Lymphocytic Thyroiditis Atypical Follicular Lesion of Undetermined Significance \/ Atypia of [&hellip;]<\/p>\n","protected":false},"author":828,"featured_media":0,"parent":46695,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-45808","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-thyroid\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"picture atlas FINE NEEDLE ASPIRATION: THYROID Here are some examples of classical conditions, organised according to categories in The Bethesda System for Reporting Thyroid Cytopathology. 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