Histopathology report

Final reports of thyroid specimens should include details on:

• the specimen type, side, size (cm) and weight (g)

• the type and subtype of tumour present, if any:

- follicular adenoma.

- papillary carcinoma and variants.

- follicular carcinoma and variants.

- medullary carcinoma.

- anaplastic carcinoma.

- lymphoma.

• the macroscopic size of tumour and degree of encapsulation.

• the presence or absence of invasion of the capsule and surrounding tissues.

• the distance of tumour from the nearest margin.

• the presence or absence of vascular invasion.

• involvement of perithyroid lymph nodes.

• other pathology such as Hashimoto's thyroiditis or radiation injury.

If other specimens are attached as an in-continuity dissection (e.g., neck dissection), these can be handled separately in the usual fashion.

• TNM classification of tumour spread of thyroid gland. Papillary, follicular and medullary carcinoma.

pT1 tumour < 2 cm, intrathyroidal.

pT2 tumour >2 to < 4 cm, intrathyroidal.

pT3 tumour > 4 cm, or minimal extrathyroidal extension.

pT4 tumour extends beyond thyroid capsule with invasion of:

a. subcutaneous tissues, larynx, trachea, oesophagus, recurrent laryngeal nerve.

b. prevertebral fascia, mediastinal vessels, carotid artery.

Anaplastic/undifferentiated carcinoma (both considered pT4).

pT4a tumour limited to thyroid*. pT4b tumour beyond thyroid capsule+.

considered surgically resectable* and unresectable+.

Regional lymph nodes.

pN0 no regional lymph nodes involved. pN1a metastasis in Level VI lymph node. pN1b metastasis in other regional lymph node(s).

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