Benign Intranodal Thyroid Tissue Similar to Nodal Metastasis of Thyroid Papillary Carcinoma: A Rare Case Report

In patients with thyroid nodules, if the cervical lymph nodes gradually enlarge, a histological confirmation is required to rule out malignancy. Here is a case of benign intranodal thyroid tissue with cystic changes resembling lymph node metastasis of a papillary thyroid carcinoma. A 47-year-old man...

Full description

Saved in:
Bibliographic Details
Published in:Diagnostics (Basel) 2023-02, Vol.13 (3), p.577
Main Authors: Kang, Yoo-Na, Cha, Jung-Guen
Format: Article
Language:English
Subjects:
Abscesses
Analysis
Autopsies
Calcification
Care and treatment
Case reports
Conflicts of interest
CT imaging
Development and progression
Diagnosis
Ethics
Hyperplasia
Interesting Images
intranodal
Lymph nodes
Lymphatic metastasis
Lymphatic system
Medical imaging
Metastasis
Mutation
Neck
papillary carcinoma
Patient outcomes
Stains & staining
Surgery
Thyroid cancer
thyroid gland
Thyroidectomy
Tomography
Ultrasonic imaging
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In patients with thyroid nodules, if the cervical lymph nodes gradually enlarge, a histological confirmation is required to rule out malignancy. Here is a case of benign intranodal thyroid tissue with cystic changes resembling lymph node metastasis of a papillary thyroid carcinoma. A 47-year-old man received ethanol sclerotherapy because of repeated enlargement of the thyroid gland 2 years prior to presentation. Subsequently, the patient underwent abscess removal from the deep neck and partial lobectomy of the attached left thyroid gland. Two months before the visit, extensive cervical lymphadenopathy was detected on ultrasonography (US) and computed tomography (CT). Total thyroidectomy and cervical lymph node dissection were performed to differentiate between metastatic papillary carcinoma of the thyroid gland and benign thyroid inclusions. Microscopic examination revealed multiple variable-sized nodules of benign thyroid follicles with cystic changes in both thyroid glands and bilateral cervical lymph nodes. An occult papillary microcarcinoma strongly positive for HBME-1 was also observed in the left thyroid lobe. However, the benign intranodal thyroid tissue was negative in both the real-time PCR-based BRAF V600E mutation test and HBME-1 immunohistochemical stain. Similarly, benign intranodal thyroid tissue can be enlarged by multiple cystic changes in a large number of lymph nodes along the neck node chain. For the differentiation of metastatic thyroid papillary carcinoma, real-time PCR-based BRAF V600E mutation test and HBME-1 immunohistochemical staining in addition to histological examination are helpful.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics13030577