Thyroid Minimally Invasive Carcinoma  

Case 1 Young female. Solitary nodule in left lobe of thyroid, FNA THY4 (equivalent to Bethesda FNA Class V) with cytology suggestive of a possible papillary carcinoma, left thyroid lobectomy. This is a Minimally Invasive Follicular Variant of Papillary Carcinoma (FVPC) comprising a well circumscribed follicular nodule with a thick fibrous capsule. There is one prominent focus of capsular invasion with associated vascular invasion. The nuclei are optically clear with nuclear features of papillary carcinoma indicating follicular variant of papillary carcinoma with microinvasion, the differential diagnosis being follicular carcinoma with micro-invasion, or follicular adenoma. 

Case 2 Child with PTEN mutation, right thyroid lobectomy. This is a Minimally Invasive Follicular Carcinoma in a child with PTEN mutation. showing foci of capsular and vascular invasion within the capsule. The phosphatidyl inositol 3-kinase PI3P/AKT kinase pathway is negatively regulated by PTEN, so mutations in PTEN are associated with thyroid malignancy,

Reference

Hou P, Ji M, Xing M. Association of PTEN gene methylation with genetic alterations in the phosphatidylinositol 3 kinase/AKT signaling pathway in thyroid tumors. Cancer 2008;113:2440