This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endocrinology and breast, Subject name: Surgery
Hashimoto&;s thyroiditis - True are all except 
Select and explain. 
A. Follicular destruction, B. Increase in lymphocytes, C. Oncocytic metaplasia, D. Orphan Annie eye nuclei
D: Orphan Annie eye nuclei
Answer: D: Orphan Annie eye nuclei 
Explanation: Cause of Hashimoto thyroiditis,is autoimmune-mediated destruction of thyrocytes. A complex immunologic phenomenon results in the formation of immunecomplexes and complement in the basement membrane of follicular cells. These cellular reactions ultimately result in the infiltration of lymphocytes and resultant fibrosis, which decreases the number and efficiency of individual follicles. Thus leading to hypothyroidism Huhle cell (oncocytes) changes are seen in Hasimotos thyroiditis. Orphan annie eye nuclei are seen in papillary carcinoma thyroid. Source Sabiston 20th edition Pg : 891