Fine needle aspiration biopsy of three cases of squamous cell carcinoma presenting as a thyroid mass: cytological findings and differential diagnosis

M. Rosa and K. Toronczyk Fine needle aspiration biopsy of three cases of squamous cell carcinoma presenting as a thyroid mass: cytological findings and differential diagnosis Objective: Primary squamous cell carcinomas of the thyroid gland are extremely rare, comprising about 1% of thyroid malignancies. Although squamous cell carcinomas are readily identified as such on aspiration cytology in the majority of cases, the differentiation of primary versus metastatic tumour might not always be easy. Herein, we report three cases of squamous cell carcinomas involving the thyroid gland. Methods: Fine needle aspiration cytology (FNAC) was performed in three patients with a thyroid mass using standard guidelines. Smears were stained with Diff‐Quik and Papanicolaou stains. Results: Two patients were male and one was female, aged 59, 45 and 35 years, respectively. In all three patients a thyroid mass was present. FNAC smears in all cases showed cytological features of squamous cell carcinoma including keratinization and necrosis. After clinical and cytological correlation, one case appeared to be primary, one case metastatic, and in the third case no additional clinical information or biopsy follow‐up was available for further characterization. Conclusions: Because primary squamous cell carcinoma of the thyroid is a rare finding, metastatic squamous cell carcinoma should always be excluded first. Metastatic disease usually presents in the setting of widespread malignancy, therefore a dedicated clinical and radiological investigation is necessary in these cases. In both clinical scenarios the patient’s prognosis is poor.     

RNA interference: unraveling a mystery

Andrew Fire and Craig Mello have won the Nobel Prize in Medicine or Physiology for their discovery of RNA interference. Mary K. Montgomery, then a postdoc in the Fire laboratory, participated in some of the key experiments.     

Prions: a mystery unravelled?

Prions result in fatal degeneration of the central nervous system (CNS) in the form of diseases known as transmissible spongiform encephalopathies (TSEs). The discovery in 1996 of a new variant of Creutzfeldt-Jakob disease (a human TSE) and experimental confirmation that it is caused by the prion strain responsible for bovine spongiform encephalopathy (BSE) has greatly spurred research in this field. The mechanism underlying prion propagation is now reasonably clear. Prions multiply, in fact, by stimulating their hosts to produce proteins that are initially normal, but acquire an abnormal, prion-like conformation during the coiling stage. A fuller understanding of this mechanism could lead to the employment of molecules capable of making prion proteins revert to the normal conformation in the treatment of both TSEs and other serious CNS disorders.