Cytomorphologic findings of thyroid carcinoma showing thymus-like (CASTLE) differentiation: A case report

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S42-S42
Author(s):  
A K Abu-Salah ◽  
S Segura ◽  
H Mesa ◽  
H M Cramer
Keyword(s):  
Case Report ◽  
Thyroid Carcinoma ◽  
Thymic Carcinoma ◽  
Needle Aspiration ◽  
Central Neck Dissection ◽  
Anaplastic Carcinoma ◽  
Thyroid Neoplasm ◽  
Squamous Differentiation ◽  
Thymic Tissue ◽  
The Right

Abstract Introduction/Objective Thyroid carcinoma showing thymus-like differentiation also known as intrathyroidal thymic carcinoma is a rare thyroid neoplasm arising from either an ectopic intrathyroidal thymic tissue or from remnants of thymobranchial pouches. On fine needle aspiration (FNA) its diagnosis can be challenging due to overlapping morphologic features with other aggressive thyroid carcinomas. Methods/Case Report A 31-year-old female consulted for 6-month history of neck swelling and tenderness. Thyroid ultrasound demonstrated a 2.6 x 2.5 x 2.1 cm nodule in the right lobe with punctate calcifications. FNA showed cellular smears composed of loosely cohesive and single basaloid neoplastic cells exhibiting significant cellular and nuclear pleomorphism. Focal squamous differentiation with keratinization was noted on the cell block sections. Immunocytochemical stains showed that the tumor was positive for cytokeratin AE1/AE3, p40, p63, CD117 and CD5 consistent with intrathyroidal thymic carcinoma. The Ki67 proliferative index was approximately 40%. A right thyroidectomy with central neck dissection confirmed the diagnosis and showed a 3.0 cm tumor with invasion into skeletal muscle, lymphovascular invasion and positive lymph nodes. The patient completed adjuvant radiotherapy and remain in remission at 3-months follow-up. Results (if a Case Study enter NA) NA Conclusion Intrathyroidal thymic carcinoma is a rare thyroid neoplasm that frequently shows squamous differentiation and therefore overlaps with papillary thyroid carcinoma with squamous morulae, squamous cell carcinoma and anaplastic carcinoma. The coexpression of squamous markers together with CD5 and CD117 allows the recognition of CASTLE on FNA samples.

scholarly journals Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Hemiagenesis ◽  
Poorly Differentiated ◽  
Node Metastases ◽  
Right Lobe ◽  
The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

scholarly journals Excessive Leukocytosis Leading to a Diagnosis of Aggressive Thyroid Anaplastic Carcinoma: A Case Report and Relevant Review

2020 ◽  
Vol 9 (3) ◽  
pp. 162-168 ◽  
Author(s):  
Antonis Polymeris ◽  
Christina Kogia ◽  
Dimitrios Ioannidis ◽  
Dimitrios Lilis ◽  
Maria Drakou ◽  
...  
Keyword(s):  
Paraneoplastic Syndrome ◽  
Myeloproliferative Neoplasms ◽  
Acute Infection ◽  
White Blood Cells ◽  
Needle Aspiration ◽  
Respiratory Arrest ◽  
Anaplastic Thyroid Carcinoma ◽  
Anaplastic Carcinoma ◽  
Tender Mass ◽  
The Right

Introduction: Leukocytosis and particularly neutrophilia are usually caused by acute infection, inflammation, and myeloproliferative neoplasms. However, leukocytosis can also occur in patients with malignancy either due to bone marrow metastases or in the context of a paraneoplastic syndrome. Case Presentation: An 86-year-old female was admitted to our hospital due to marked leukocytosis (white blood cells [WBC] >40,000/μL), neutrophilia, and monocytosis. She was afebrile and reported hoarseness and mild difficulty swallowing. Upon physical examination, lung auscultation revealed inspiratory wheezing and a non-tender mass was observed in the anterior midline of the neck. Blasts and immature WBC were not found, and polymerase chain reaction for the detection of BCR/ABL gene was negative. A mass (5.4 cm in diameter) of abnormal parenchymal composition with calcifications occupying the right lobe, was seen on thyroid ultrasound. Cytology, after fine-needle aspiration, showed an anaplastic thyroid carcinoma (ATC). The cervical and chest computed tomography scan revealed a low-density lesion with calcifications that shifts and presses the trachea and multiple lung nodular lesions bilaterally. Since the case was inoperable and the airway was severely obstructed, a DUMON stent was placed. Biopsy of specimens from the trachea lesion revealed a tumor with significant atypical cells and focal squamoid features. The patient’s WBC increased to 72,470/μL. Additionally, interleukin-6 (IL-6) was markedly elevated (20.2 pg/mL). The patient passed away due to respiratory arrest 55 days after her initial admission. Discussion: Excessive leukocytosis in a patient, having excluded infectious disease and myelodysplastic syndrome, could represent a manifestation of a paraneoplastic syndrome due to various cytokines secretion from the tumor. In our case, ATC synthesized and secreted IL-6, which seems to be the cause of severe leukocytosis.

Thyroid carcinoma of a guinea-pig: a case report

1974 ◽  
Vol 8 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Kh. Zarrin
Keyword(s):  
Case Report ◽  
Guinea Pig ◽  
Thyroid Carcinoma ◽  
Spindle Cell ◽  
Thyroid Neoplasm ◽  
Cell Element ◽  
Multiple Tumour

Multiple tumour nodules arising in the thyroid of a guinea-pig consisted histologically of a mixture of carcinoma with an ossifying spindle-cell element. No metastases were detected. This type of thyroid neoplasm has not hitherto been reported in the guinea-pig.

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