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Signet Ring Cells in a Poorly Differentiated Hurthle Cell Carcinoma of the Thyroid Combined With Two Papillary Microcarcinomas

follicles with dot-like lumina containing scanty to absent colloid were detected, admixed with truly solid areas (Figure 1). The neoplastic thyrocytes had abundant granular acidophilic cytoplasm and large hyperchromatic nuclei with prominent nucleoli (ie, the typical features of Hurthle cell tumors [Figure1, A30-year-old woman with a several-year history of lymphocytic thyroiditis underwent a left thyroidectomy for a thyroid nodule. Grossly the lobe was mostly occupied by a round tan-brown nodule measuring 3.5 cm at its greatest dimension. The surrounding parenchyma was unremarkable. Microscopically, the lesion exhibited a multinodular solid pattern of growth. At higher magnification,