title: Fine needle aspiration of follicular variant of papillary thyroid carcinoma presenting with pleural effusion: a case report.
abstract: BACKGROUND
  Malignant pleural effusion in association with mesothelioma, bronchogenic carcinoma and breast carcinoma is common, although less frequently reported with other malignancies. We report a follicular variant of papillary thyroid carcinoma (FVPTC), diagnosed on fine needle aspiration cytology (FNAC) of thyroid and lymph nodes and subsequently proved to have metastasized to the pleural cavity.
  
  
  METHODS
  A 46-year-old man presented with history of breathlessness, thyroid swelling, pleural effusion and bilateral cervical lymphadenopathy. FNAC of the thyroid swelling and the lymph nodes showed features of FVPTC with cervical lymph node metastasis. Pleural fluid examination led to suspicion of pleural involvement by metastatic deposit, confirmed by subsequent pleural biopsy.
  
  
  CONCLUSIONS
  Thyroid malignancies presenting with pleural effusion are rare. In this case, although pleural fluid cytology suggested involvement of pleura, a definitive diagnosis could be rendered only on pleural biopsy. An ancillary aid, such as immunocytochemistry, could have helped establish pleural involvement on routine pleural fluid cytology alone. This case emphasizes the possible existence of rare cases of FVPTC that may be associated with a dismal prognosis. In our case, initial diagnosis of FVPTC could be made only on correlating FNA features of thyroid aspirate with those of lymph node aspirate.
authors: Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. rajusiddaraju@yahoo.com
authors: Neelaiah
authors: N
authors: Siddaraju
authors: Vinod Kumar
authors: VK
authors: Viswanathan
authors: Vinod Kumar
authors: VK
authors: Saka
authors: Debdatta
authors: D
authors: Basu
authors: Chandrakumar
authors: C
authors: Shanmugham
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle / Q000379:methods*; D018265:Carcinoma, Papillary, Follicular / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010996:Pleural Effusion / Q000175:diagnosis*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000628:therapy
chemical_list: D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil