title: Follicular carcinoma of the thyroid with hyperthyroidism. A case report.
abstract: BACKGROUND
  Follicular carcinoma of the thyroid in association with hyperthyroidism is rare. The malignant lesion may remain occult for a long time. Certain clinical and cytologic features may be helpful in raising the alarm.
  
  
  METHODS
  An elderly male with a history of occupational exposure to X rays, long-standing toxic multinodular goiter and clinical hyperthyroidism presented with a rapidly enlarging mass in the neck. Cytologic smears showed a prominent microfollicular pattern, scanty colloid, anisonucleosis and nuclear overlapping. The noteworthy feature was the presence of marginal vacuoles. The cytologic diagnosis of follicular neoplasm with highly suggestive malignancy was made. Subsequently, multiple pulmonary nodules provided radiologic evidence of possible metastatic spread.
  
  
  CONCLUSIONS
  This case report demonstrates the rare association of follicular carcinoma of the thyroid with hyperthyroidism and analyzes certain high-risk clinical and cytologic features to be considered in the follow-up of long-standing hyperfunctioning multinodular goiter.
authors.affiliation: Cytopathology Laboratory, Department of Pathology, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Sharma
authors.forename: Neeta
authors.initials: N
authors.lastname: Kumar
authors.forename: Ruchika
authors.initials: R
authors.lastname: Gupta
authors.forename: Shyama
authors.initials: S
authors.lastname: Jain
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary; D006042:Goiter / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006980:Hyperthyroidism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D016273:Occupational Exposure; D011859:Radiography; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D013964:Thyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D014965:X-Rays / Q000009:adverse effects