J Korean Thyroid Assoc.  2015 May;8(1):121-124. 10.11106/cet.2015.8.1.121.

A Case of Papillary Thyroid Carcinoma Coexistent with Thyroid Sarcoidosis

Affiliations
  • 1Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. ho3632@dsmc.or.kr
  • 2Raphael Hospital, Daegu, Korea.
  • 3Department of Pathology, Keimyung University Dongsan Medical Center, Daegu, Korea.

Abstract

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. The involvement of thyroid gland with sarcoidosis is uncommon. Moreover, sarcoidosis with thyroid cancer are rarely reported in the world. We encountered papillary thyroid carcinoma (PTC) coexistent with pulmonary sarcoidosis. A 35-year-old female with a medical history of pulmonary sarcoidosis visited the endocrinology department for evaluation of the thyroid nodule. Thyroid ultrasonography showed multiple markedly hypoechoic nodules in the left thyroid lobe. Then ultrasonogram-guided fine needle aspiration of left thyroid nodule was positive for papillary carcinoma. She underwent total thyroidectomy with left complete cervical lymph node dissection. The histopathology was confirmed PTC combined with non-caseating granulomatous inflammation suggesting sarcoidosis on thyroid mass and lymph node. We report here a case of PTC coexistent with thyroid involvement of pulmonary sarcoidosis.

Keyword

Thyroid sarcoidosis; Papillary thyroid carcinoma

MeSH Terms

Adult
Biopsy, Fine-Needle
Carcinoma, Papillary
Endocrinology
Female
Humans
Inflammation
Lung
Lymph Node Excision
Lymph Nodes
Lymphatic System
Sarcoidosis*
Sarcoidosis, Pulmonary
Thyroid Gland*
Thyroid Neoplasms*
Thyroid Nodule
Thyroidectomy
Ultrasonography

Figure

  • Fig. 1. Chest CT shows bilateral hilar lymphadenopathy (A, arrows) and thyroid nodule located in left lower thyroid gland (B, arrow).

  • Fig. 2. (A) Thyroid tumor masses are composed of microfollicles with typical cytologic features of papillary carcinoma (H&E, ×400). (B) Scattered foci of non-caseous granulomas are surrounded with chronic inflammatory cells and atrophied follicles (H&E, ×200). (C) Neck lymph nodes show involvement of non-caseous granulomas (H&E, ×40). (D) High power view of granulomas in lymph node consists of many epithelioid histiocytes and inflammatory cells without necrosis (H&E, × 200).


Reference

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