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Lee H, States LJ. Langerhans Cell Histiocytosis With Thyroid Involvement on 18 F-FDG PET/MR. Clin Nucl Med 2023; 48:1053-1055. [PMID: 37756470 DOI: 10.1097/rlu.0000000000004822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
ABSTRACT An 18-month-old otherwise healthy girl presented with 1 month of neck swelling. Based on ultrasonography that showed diffusely enlarged heterogeneous thyroid gland, a presumed diagnosis of thyroid cancer was made. Subsequent core needle biopsy revealed Langerhans cell histiocytosis extensively involving the thyroid. 18 F-FDG PET/MR was performed for staging and to evaluate the local extent of the disease in the neck. PET/MR demonstrated a hypermetabolic neck mass inseparable from the thyroid gland. The mass encased the major vessels, trachea, and esophagus without compression or invasion. Osseous involvement was excluded by both skeletal survey and PET/MR.
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Affiliation(s)
| | - Lisa J States
- From the Department of Radiology, University of Pennsylvania Perelman School of Medicine
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2
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Shi JJ, Peng Y, Zhang Y, Zhou L, Pan G. Langerhans cell histiocytosis misdiagnosed as thyroid malignancy: A case report. World J Clin Cases 2023; 11:1152-1157. [PMID: 36874420 PMCID: PMC9979281 DOI: 10.12998/wjcc.v11.i5.1152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/31/2022] [Accepted: 01/28/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND The incidence of Langerhans cell histiocytosis (LCH) is low, and involvement of the thyroid is even rarer, which results in high missed diagnosis or misdiagnosis rates.
CASE SUMMARY We report a young woman with a thyroid nodule. Thyroid malignancy was suggested by fine needle aspiration, but she was eventually diagnosed with multisystem LCH, thus avoiding thyroidectomy.
CONCLUSION The clinical manifestations of LCH involving the thyroid are atypical, and the diagnosis depends on pathology. Surgery is the main method for treating primary thyroid LCH, while chemotherapy is the main treatment method for multisystem LCH.
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Affiliation(s)
- Jing-Jing Shi
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - You Peng
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Yu Zhang
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Li Zhou
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Gang Pan
- Department of Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
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3
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Wanqing TMD, Xiaojuan ZMD, Xiuyun TMD, Xinya WMD, Mingzhu ZMD, Cheng ZMD. Ultrasound of Thyroid Langerhans Cell Histiocytosis with Papillary Thyroid Carcinoma: A Report of Two Cases and Literature Review. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2023. [DOI: 10.37015/audt.2023.210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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4
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Li Y, Chang L, Chai X, Liu H, Yang H, Xia Y, Huo L, Zhang H, Li N, Lian X. Analysis of thyroid involvement in children and adult Langerhans cell histiocytosis: An underestimated endocrine manifestation. Front Endocrinol (Lausanne) 2022; 13:1013616. [PMID: 36246871 PMCID: PMC9562644 DOI: 10.3389/fendo.2022.1013616] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Langerhans cell histiocytosis (LCH) is a rare disease caused by the clonal expansion of CD1a+/CD207+ LCH cells. The thyroid involvement in LCH has mostly been described in case reports. METHODS We retrospectively evaluated the clinical characteristics, diagnosis, and treatment of 27 children and adult patients with thyroid LCH in our center between 2010 and 2021. RESULTS The incidence of thyroid LCH was 14.00% (7/50) in children and 10.10% (20/198) in adults, respectively. Among patients with thyroid involvement, 81.5% presented with diabetes insipidus (DI) as the first symptom, and 51.9% complained of neck swelling or mass. Children and adults with thyroid LCH had higher frequencies of the hypothalamic-pituitary axis (HPA) (children: 100% vs. 62.8%, P=0.05; adult: 95% vs. 42.1%, P<0.001), the lung (children: 85.7% vs. 25.6%, P=0.004; adult: 70% vs. 50.6%, P=0.099), and a lower frequency of bone (children: 14.3% vs. 55.8%, P=0.049; adult: 45% vs. 73.6%, P=0.008) involvement than patients without thyroid involvement. Patients with thyroid LCH had a higher frequency of primary hypothyroidism and a lower frequency of euthyroidism than patients without it. The two major types of ultrasound imaging were diffuse (55%) and nodular type (45%). The standardized uptake value of thyroid on 18-F-fluorodeoxyglucose positron emission tomography/computed tomography was 5.3-12.8. The diagnoses were confirmed using thyroid aspiration (54.5%) or surgery (45.5%). In addition, thyroid LCH combined with papillary thyroid carcinoma was not rare (2/27). CONCLUSION Thyroid involvement in LCH is not rare. Furthermore, identifying thyroid involvement can facilitate the pathological diagnosis of LCH. Therefore, the possibility of thyroid LCH should be fully investigated in patients with DI, primary hypothyroidism, abnormal thyroid ultrasound results, and multi-system disease. In addition, thyroid aspiration can confirm suspected thyroid LCH. Finally, special attention should be paid to evaluating HPA and pulmonary involvement in thyroid LCH.
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Affiliation(s)
- Yuanmeng Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Long Chang
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaofeng Chai
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - He Liu
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongbo Yang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Xia
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Huo
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Zhang
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Clinical Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Naishi Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Naishi Li, ; Xiaolan Lian,
| | - Xiaolan Lian
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Naishi Li, ; Xiaolan Lian,
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5
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Ismayilov R, Aliyev A, Aliyev A, Hasanov I. Langerhans Cell Histiocytosis of Thyroid Gland in a Child: A Case Report and Literature Review. Eurasian J Med 2021; 53:148-151. [PMID: 34177300 DOI: 10.5152/eurasianjmed.2021.20144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Rashad Ismayilov
- Department of Nuclear Medicine, Azerbaijan National Center of Oncology, Baku, Azerbaijan
| | - Anar Aliyev
- Department of Nuclear Medicine, Azerbaijan National Center of Oncology, Baku, Azerbaijan
| | - Aziz Aliyev
- Department of Head and Neck Surgery, Azerbaijan National Center of Oncology, Baku, Azerbaijan
| | - Ilgar Hasanov
- Department of Pathology, Azerbaijan National Center of Oncology, Baku, Azerbaijan
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6
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Rossi ED, Pantanowitz L, Hornick JL. Cytologic and histological features of rare nonepithelial and nonlymphoid tumors of the thyroid. Cancer Cytopathol 2021; 129:583-602. [PMID: 33493367 DOI: 10.1002/cncy.22404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 11/09/2022]
Abstract
Thyroid tumors can be classified into epithelial, nonepithelial, and nonprimary lesions. Nonepithelial thyroid tumors are rare. They can be of primary origin within the thyroid gland, arise secondary to contiguous growth from adjacent tissues, or represent metastatic disease. The incidence of nonepithelial tumors of the thyroid is only 1% to 2%, most of which are lymphomas; the remainder includes mesenchymal and histiocytic tumors. This review examines the cytohistological features of various nonepithelial and nonlymphoid tumors of the thyroid, including vascular lesions, neural tumors (including granular cell tumor and paraganglioma), smooth muscle tumors, solitary fibrous tumor, histiocytic neoplasms (eg, Langerhans cell histiocytosis and Rosai-Dorfman disease), and follicular dendritic cell sarcoma. Their differential diagnosis is discussed, including recommendations to prevent the pitfall of mistaking these rare tumors for more common epithelial thyroid neoplasms.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Catholic University of Sacred Heart, Rome, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Ozisik H, Yurekli BS, Demir D, Ertan Y, Simsir IY, Ozdemir M, Erdogan M, Cetinkalp S, Ozgen G, Saygili F. Langerhans cell histiocytosis of the thyroid together with papillary thyroid carcinoma. Hormones (Athens) 2020; 19:253-259. [PMID: 32314308 DOI: 10.1007/s42000-020-00181-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Hatice Ozisik
- Division of Endocrinology and Metabolism, Ege University, İzmir, Turkey.
| | | | - Derya Demir
- Division of Pathology, Ege University, İzmir, Turkey
| | - Yesim Ertan
- Division of Pathology, Ege University, İzmir, Turkey
| | | | - Murat Ozdemir
- Division of General Surgery, Ege University, İzmir, Turkey
| | - Mehmet Erdogan
- Division of Endocrinology and Metabolism, Ege University, İzmir, Turkey
| | - Sevki Cetinkalp
- Division of Endocrinology and Metabolism, Ege University, İzmir, Turkey
| | - Gokhan Ozgen
- Division of Endocrinology and Metabolism, Ege University, İzmir, Turkey
| | - Fusun Saygili
- Division of Endocrinology and Metabolism, Ege University, İzmir, Turkey
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8
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Langerhans Cell Histiocytosis of the Thyroid Leading to the Diagnosis of a Disseminated Form. Case Rep Endocrinol 2020; 2020:6284764. [PMID: 32257462 PMCID: PMC7103030 DOI: 10.1155/2020/6284764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/28/2019] [Accepted: 01/21/2020] [Indexed: 01/08/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare sporadic proliferative disorder of Langerhans cells. LCH rarely involves the thyroid gland. We report herein a case of a disseminated chronic form of LCH with a diagnosis established by histological examination of the thyroid gland. It is about a 37-year-old female who underwent total thyroidectomy for a thyroid nodule of the right lobe. Histological study showed a granulomatous thyroiditis, and the immunohistochemistry study revealed a strong positivity of histiocytes for the CD1 antigen and for the S100 protein. The incidence of LCH involving the thyroid gland, either as an isolated lesion or as a part of multisystemic disease, is extremely rare.
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9
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Özgüven MB, Özakkoyunlu Hasçiçek S, Uslu Coşkun B, Polat N, Kabukçuoğlu F. Tiroid bezinde Langerhans hücreli histiyositoz. CUKUROVA MEDICAL JOURNAL 2018. [DOI: 10.17826/cumj.332333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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10
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Montefusco L, Harari S, Elia D, Rossi A, Specchia C, Torre O, Adda G, Arosio M. Endocrine and metabolic assessment in adults with Langerhans cell histiocytosis. Eur J Intern Med 2018; 51:61-67. [PMID: 29198444 DOI: 10.1016/j.ejim.2017.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 11/26/2017] [Accepted: 11/27/2017] [Indexed: 12/22/2022]
Abstract
CONTEXT Diabetes insipidus (DI) is one of most common complications of Langerhans cell histiocytosis (LCH) but prevalence of anterior pituitary deficiencies and metabolic alterations have not been clearly defined yet. OBJECTIVES Evaluate prevalence of endocrine and metabolic manifestations in a cohort of patients affected by Pulmonary LCH. METHODS Observational cross-sectional study on 18 adults (7 M/11 F, 42±12years) studied for complete basal and dynamic endocrine lab tests and glucose metabolism. RESULTS Hypothalamic-pituitary endocrine alterations were found in 9 patients: 9 had DI, 5 Growth Hormone Deficiency (GHD), 5 central hypogonadism, 3 central hypothyroidism and 1 central hypoadrenalism. Hyperprolactinemia and hypothalamic syndrome were found in 2 patients each. All these central endocrine alterations were always associated to DI. Five of the 10 MRI performed showed abnormalities. Prevalence of obesity and glucose alterations (either DM or IFG/IGT) were respectively 39% and 33%, higher than expected basing on epidemiological data on general Italian population. Multi-system-LCH without risk-organ involvement (LCH MS-RO-) seems to have slightly higher prevalence of insulin resistance, glucose alterations and metabolic syndrome than LCH with isolated lung involvement (LCH SS lung+). A papillary BRAFV600E positive thyroid carcinoma was diagnosed in one patient. CONCLUSIONS The presence of anterior pituitary deficiencies should be systematically sought in all LCH patients with DI both at diagnosis and during the follow-up by basal and dynamic hormonal assessment. Patients with pulmonary LCH, particularly those with MS disease, have a worse metabolic profile than general population. Occurrence of papillary thyroid carcinoma has been reported.
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Affiliation(s)
- L Montefusco
- U.O. di Malattie Endocrine e Diabetologia, Ospedale San Giuseppe Multimedica, Milan, Italy; MultiMedica IRCCS, Milan, Italy
| | - S Harari
- MultiMedica IRCCS, Milan, Italy; U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria - Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe Multimedica, Milan, Italy.
| | - D Elia
- MultiMedica IRCCS, Milan, Italy; U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria - Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe Multimedica, Milan, Italy
| | - A Rossi
- U.O. di Malattie Endocrine e Diabetologia, Ospedale San Giuseppe Multimedica, Milan, Italy; MultiMedica IRCCS, Milan, Italy
| | - C Specchia
- MultiMedica IRCCS, Milan, Italy; Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Italy
| | - O Torre
- MultiMedica IRCCS, Milan, Italy; U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria - Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe Multimedica, Milan, Italy
| | - G Adda
- U.O. di Malattie Endocrine e Diabetologia, Ospedale San Giuseppe Multimedica, Milan, Italy; MultiMedica IRCCS, Milan, Italy
| | - M Arosio
- U.O. di Endocrinologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
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11
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Vargas D, Richards JC, Ocazionez D, Sirajuddin A, Browne L, Restrepo CS. Cardiothoracic manifestations of primary histiocytoses. Br J Radiol 2016; 89:20160347. [PMID: 27603510 DOI: 10.1259/bjr.20160347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The objectives of this article were: (1) to review common and rare manifestations of systemic and pulmonary Langerhans cell histiocytosis, Rosai-Dorfman disease, Erdheim-Chester disease and juvenile xanthogranuloma; (2) to provide the reader with important pathologic, epidemiologic and clinical features of these diseases. The histiocytoses are a diverse group of diseases which typically manifest with multiorgan involvement. Understanding the pathologic, epidemiologic and clinical features of these entities can help the radiologist suggest an accurate diagnosis of histiocytosis when typical imaging features are encountered.
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Affiliation(s)
- Daniel Vargas
- 1 Department of Radiology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - J Caleb Richards
- 6 Department of Radiology, National Jewish Health. Denver, CO, USA
| | - Daniel Ocazionez
- 2 Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Arlene Sirajuddin
- 3 Department of Medical Imaging, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Lorna Browne
- 4 Department of Radiology, Children's Hospital of Colorado, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Carlos S Restrepo
- 5 Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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12
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Picarsic J, Jaffe R. Nosology and Pathology of Langerhans Cell Histiocytosis. Hematol Oncol Clin North Am 2015; 29:799-823. [DOI: 10.1016/j.hoc.2015.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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Bing Y, Jing G, Chang-You W, Xue-Ming W, Chun-Xiu L, Yuan-Yuan T, Nai-Yao C, Zhen-Yu Y. Langerhans Cell Histiocytosis Presenting as Endocrine Disorders in an Adult Patient: A Case Report. AACE Clin Case Rep 2015. [DOI: 10.4158/ep14392.cr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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14
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Langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying metastatic thyroid papillary carcinoma. Case Rep Pathol 2014; 2014:184237. [PMID: 25349760 PMCID: PMC4202248 DOI: 10.1155/2014/184237] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 08/20/2014] [Indexed: 11/17/2022] Open
Abstract
A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma.
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15
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Znati K, Sekal M, Chbani L, Elfatemi H, Harmouch T, Amarti A. [Very rare cause of diffuse goiter]. Ann Pathol 2013; 33:352-4. [PMID: 24238251 DOI: 10.1016/j.annpat.2013.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 06/12/2013] [Accepted: 08/30/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Kaoutar Znati
- Service d'anatomie pathologique, CHU Hassan II, Fès, Maroc; Laboratoire de biologie des cancers, faculté de médecine de Fès, Fès, Maroc.
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