Özet:

Diffuse sclerosing variant is an uncommon variant of papillary thyroid carcinoma. The biological behavior and prognostic outcome of this variant are still controversial. The aim of this report is to analyse the features of this entity. A 32-year-old male patient who presented with the complaint of palpitations was diagnosed with hyperthyroidism by clinical evaluation. Hyperechoic heterogeneous microcalcifications were detected in the right lobe on ultrasound radiography. Fine needle aspiration was performed from the right lobe and the lymph node. Abundant psammomatous calcification and follicular epithelial cell groups that suggest the nuclear properties of papillary carcinoma were observed. It was reported as malignant cytology. Bilateral total thyroidectomy was planned. In the macroscopic evaluation, irregularly limited nodule-like area, the largest size of which was about 35 millimeters, was noticed in the right lobe. Histopathological examination revealed a diffuse-widespread lymphocytic infiltration and intense psammomatous calcification, which holds the entire lobe. Micropapillary groups showing nuclear properties of papillary carcinoma were observed, especially in areas rich in connective tissue, with marked dilated lymphatic and lymphatic-like spaces. Very few areas had typical papillary carcinoma features. With the current findings, the case was diagnosed with diffuse sclerosing variant papillary thyroid carcinoma. The patient is healthy for 15 months after the treatment. Although the papillary carcinoma of the thyroid generally has a good prognosis, the diffuse sclerosing variant has an aggressive course and poor prognosis. The correct identification of this variant, which can cause differential diagnosis problems with benign thyroid lesions both cytopathologically and histopathologically, is very important in terms of appropriate treatment

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