Cribriform Morular Thyroid Carcinoma: Unreported Cytological Features With Histologic Correlation and Diagnostic Lessons From a Case Lacking Morules.
Sonali Dixit, Surabhi Jain, Shipra Agarwal et al.
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Case in brief
A 29-year-old woman presented with a solitary nodule in the left thyroid lobe, which was solid with microcalcifications on ultrasound. Fine-needle aspiration cytology revealed moderately cellular smears with features mimicking papillary thyroid carcinoma, including microfollicles and a jigsaw puzzle pattern. Total thyroidectomy confirmed cribriform morular thyroid carcinoma, despite the absence of morules, highlighting the importance of recognizing specific cytological features.
What made this case unusual
The case is notable for the absence of morules, which are typically associated with cribriform morular thyroid carcinoma, yet the cytological features still correlated with the histological diagnosis.
Diagnostic / clinical pearl
Clinicians should be aware that cribriform morular thyroid carcinoma can present without morules, and cytological features such as complex architectural patterns and the absence of colloid are critical for accurate diagnosis.
Why it matters
This case underscores the diagnostic challenges posed by rare thyroid neoplasms and the need for pathologists to recognize atypical presentations to avoid misdiagnosis.