Some of the characteristic features of subacute or granulomatous thyroiditis overlap with those of a papillary thyroid carcinoma, especially the presence of large giant cells. It is important to realize that the presence of numerous multinucleated giant cells does not rule out the diagnosis of papillary thyroid carcinoma. In this instance, the key for differential diagnosis is not to miss the rarely existed tissue fragment of follicular cells with characteristic nuclear features of papillary thyroid carcinoma. Clean background, almost without inflammatory cells admixed, and “bubble gum” colloid as well as the presence of two types of multinucleated giant cells are not in favor of the diagnosis of subacute thyroiditis.
Giant cells Histiocytic type Follicular cell type Striated muscle cell type Papillary carcinoma
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