q5 - kola

[ArchivalUser]

A 40-year-old male presents with a solitary, midline, anterior neck mass. He noticed it 2 weeks ago and states it not painful. Review of systems is negative for symptoms. Physical exam demonstrates a 2cm, firm, nontender nodule on the right side of the neck. The patient elects to undergo FNA. Which of the following thyroid carcinomas cannot be diagnosed using FNA?

1. Medullary
2. Anaplastic
3. Follicular
4. Papillary

[ArchivalUser]

3.?

[ArchivalUser]

3 is right

[ArchivalUser]

right

[ArchivalUser]

v good q

[ArchivalUser]

Follicular carcinoma and Hurthle cell carcinoma cannot be diagnosed by FNA biopsy. This is an important point. Since benign follicular adenomas cannot be differentiated from follicular cancer (~12% of all thyroid cancers) these patients often end up needing a formal surgical biopsy, which usually entails removal of the thyroid lobe which harbors the nodule.