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Background: Follicular thyroid carcinomas (FTCs) usually have a benign clinical course, with an excellent long-term prognosis and a propensity for vascular invasion. The most common sites of metastases are lung and bone. Only a few reports are available on fine needle aspiration biopsy findings from metastatic lesions of FTC., Cases: A 68-year-old man presented with a thyroid mass and skin nodule on the scalp. Skin nodule aspiration revealed metastatic FTC. A 52-year-old woman and 60-year-old man were investigated for chronic anemia. As part of the routine investigation, bone marrow aspiration and biopsy were performed from the posterior iliac crest and diagnosed as metastatic FTC. Further questioning revealed that the patients had undergone thyroidectomy 10 and 13 years earlier. The aspiration material in all 3 cases revealed epithelial cell clusters with marginal (fire-flare) vacuoles., Conclusion: Cytologic diagnosis of metastatic FTC has been reported rarely. Marginal (fire-flare) vacuoles aid in making the diagnosis of metastatic FTC.

Objective: To describe some rare cytologic findings in medullary thyroid carcinoma., Study Design: Review of the fine needle aspiration smears from 15 cases of medullary thyroid carcinoma that were confirmed on histologic sections. The ages ranged between 31 and 67 years; 10 were female and 5 male. Thirteen were sporadic forms, and two were familial forms., Results: Eight cases were classified as pleomorphic cell type and seven as monomorphic cell type. The smears revealed round, oval, triangular, polygonal and spindle-shaped cells, intracytoplasmic red granules, occasional intranuclear inclusions, amyloid, binucleated and multinucleated cells, and thick, granular chromatin., Conclusion: The rare cytologic findings in this study were grape cells, cytoplasmic nippling, elongated cytoplasmic processes, carrot-shaped nuclei, nuclear buddings, mast cell-like cells and a Burkitt's lymphoma-like appearance. These findings were rarely reported before.

Background: Primary squamous cell carcinoma of the thyroid is a rare malignant tumor that needs to be distinguished from other neoplasms., Cases: Two males aged 65 and 68 years presented with an enlarged right lobe of the thyroid. Thyroid scintigraphy revealed a cold nodule. Clinically malignancy was suspected. Fine needle aspiration (FNA) revealed numerous clusters and isolated malignant cells, dyskeratotic cells and deposits of eosinophilic granular keratin material. Subtotal thyroidectomy was performed. Histologic findings confirmed the cytologic diagnosis of squamous cell carcinoma., Conclusion: Primary squamous cell carcinoma of the thyroid is a rare tumor. FNA findings of this tumor were not reported before. FNA study cannot help to differentiate primary from metastatic squamous cell carcinoma of the thyroid.

Objective: To study the cytologic findings of follicular variant of papillary thyroid carcinoma (FVPTC) and to compare them with the cytologic findings on other thyroid lesions., Study Design: The study group consisted of aspirate smears from 15 cases of histologically proven FVPTC. The control group consisted of 152 cases, including adenomatous colloid goiter (70), usual papillary carcinoma (40), follicular adenoma (30), Hürthle cell neoplasm (7) and medullary carcinoma (5)., Results: The smears of FVPTC revealed numerous colloid balls in the background, multilayered microfollicles (rosettes), numerous nuclear grooves and inclusions in the monolayer sheets of follicular cells, very rare giant cells, absence of calcification and papillary clusters. Rosettelike microfollicles and numerous colloid balls were not seen in the control group., Conclusion: The combination of numerous colloid balls and rosettelike microfollicles was frequently seen in FVPTC. This combination was not observed in the control group.

Background: Papillary Hürthle cell carcinoma with lymphoplasmacytic stroma is a newly recognized variant of papillary carcinoma of the thyroid gland. Fine needle aspiration findings reveal some points that have not been reported previously., Case: A 50-year-old female presented with a left lobe thyroid mass. Fine needle aspiration of the nodule yielded cellular smears, mostly in large and small papillary clusters of Hürthle cells, with nuclear grooves and rare nuclear inclusions in a lymphoplasmacytic background. Isolated Hürthle cell and multinucleated giant cells were also seen. Histopathologic examination of the 3-cm-diameter nodule showed papillary Hürthle cell carcinoma with lymphocytic stroma, or "Warthin-like tumor" of the thyroid, with capsular invasion., Conclusion: The presence of papillary clusters with nuclear features of papillary carcinoma and oxyphilic cytoplasm in a lymphoplasmacytic background should raise the diagnosis of Warthin-like tumor of the thyroid.

Background: Thyroid diseases are common among the female population in Iran; the main one is endemic colloid goiter. Thyromegaly can be due to neoplastic and nonneoplastic disorders. The clinical distinction between benign and malignant tumors of the thyroid gland is sometimes difficult. Fine needle aspiration (FNA) study can be used as a preliminary step for identifying such lesions., Cases: Two female patients aged 54 and 62 years were admitted to Nemazi Hospital, Shiraz, Iran, with the chief complaint of weight loss, rapid enlargement of the thyroid gland for the last few months and pressure symptoms in the neck. Clinically these cases were diagnosed as malignant thyroid lesions. However, for further diagnosis the tumors were aspirated. The smears revealed numerous osteoclastlike giant cells with intranuclear inclusions and numerous, isolated oval to spindle-shaped malignant cells. The smears were diagnosed as osteoclastlike anaplastic carcinoma of the thyroid., Conclusion: FNA is useful in the diagnosis of osteoclastomalike anaplastic carcinoma of the thyroid.