A six-year-old boy with a suspicious thyroid nodule: intrathyroidal thymic tissue
| Autor: | Claudia K. Vogel, Carlos Hernandez-Cassis, Anna Poniecka, J. Maxwell McKenzie |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Pathology medicine.medical_specialty Endocrinology Diabetes and Metabolism Population Thymus Gland Choristoma Diagnosis Differential Endocrinology medicine Humans Thyroid Nodule education Child education.field_of_study business.industry Thyroid Lymphoblastic lymphoma Calcinosis Nodule (medicine) medicine.disease Thyroid Diseases Lymphoma Thymic Tissue medicine.anatomical_structure Calcitonin Cervical lymph nodes medicine.symptom business |
| Zdroj: | Thyroid : official journal of the American Thyroid Association. 18(3) |
| ISSN: | 1050-7256 |
| Popis: | Ectopic intrathyroidal thymus tissue that forms mass lesions as a consequence of aberrant thymic migration during embryogenesis is rarely reported in the literature.We present the case of a 6-year-old boy with a right thyroid nodule and bilateral cervical lymph nodes. Thyroid hormone, antibodies, and routine chemistry tests were normal. Real-time thyroid ultrasound showed a right calcified nodule measuring 8 x 5 x 7 mm and multiple bilateral cervical lymph nodes. I131 scan showed mild decreased uptake in the right upper lobe. On fine-needle aspiration biopsy we discovered an atypical lymphoid proliferation that was suspicious, although not diagnostic, of a lymphoma. Immunostain for calcitonin was negative. Flow cytometry of the thyroid nodule aspirate demonstrated an abnormal polyclonal T cell population with dual expression of CD4 and CD8, and a subpopulation of cells that expressed TdT suggesting the possibility of lymphoblastic lymphoma. DNA analysis, as well as polymerase chain reaction for T cell and B cell gene rearrangement, did not demonstrate changes in the gene for the heavy chain of immunoglobulin of B cells and gamma chain of the T cell receptor. Lymph node aspirate showed unremarkable T and B lymphoid cells.The diagnosis of ectopic intrathyroidal thymus was made after the operation.Ectopic thymus tissue should be considered in the differential diagnosis of thyroid masses, especially in children. |
| Databáze: | OpenAIRE |
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