Cytology of suture granuloma in a recurrent thyroid nodule

Foreign body giant cell (FBGC) reaction leading to suture granu-loma is known to occur in response to suture material used during surgery. It occurs most commonly in the gastrointestinal tract (GIT). It is rare to find a suture granuloma in the thyroid. After ex-tensive search of the literature, it was found that such a lesion has been reported so far on guided aspirates, but not on fine needle aspiration cytology (FNAC) alone. The cytomorphology on FNAC is important to clinch the diagnosis and avoid unnecessary surgery as it can mimic a malignant thyroid nodule, multinodular goiter or a metastatic lymph node. This is the first case report of such a lesion to date. We report a 54 year old male with a recurrent firm thyroid nodule on the right side of the neck, for whom FNAC was done. It was reported as a suture granuloma on cytology. Hence the case was managed conservatively since malignancy was ruled out.