Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma

Tuberculous (TB) lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC) since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV-) PTC. Lymph node examination, however, revealed TB lymphadenitis, and the patient was given standard antimycobacterial therapy. This is the first documented case in Southeast Asia, a high TB burden region. This is also the first report involving FV-PTC, which has features between those of conventional PTC and follicular thyroid carcinoma. The case suggests that, in endemic areas, TB should be a differential in the etiology of cervical lymphadenopathy in PTC patients. In developed countries, this differential diagnosis is also valuable because of the increasing incidence of HIV and TB coinfection. Proper preoperative evaluation is important and needs to be highlighted in the formulation of local guidelines.

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Tuberculous lymphadenitis mimicking nodal metastasis in follicular variant papillary thyroid carcinoma

Endocrine Abstracts ◽

10.1530/endoabs.41.ep382 ◽

2016 ◽

Author(s):

Marc Gregory Yu ◽

Jenny Maureen Atun

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Nodal Metastasis ◽

Tuberculous Lymphadenitis ◽

Papillary Thyroid ◽

Follicular Variant

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Lateral cervical lymph node metastases from papillary thyroid carcinoma: Predictive factors of nodal metastasis

Surgery ◽

10.1016/j.surg.2011.02.003 ◽

2011 ◽

Vol 150 (1) ◽

pp. 116-121 ◽

Cited By ~ 45

Author(s):

Yun-Sung Lim ◽

Jin-Choon Lee ◽

Yoon Se Lee ◽

Byung-Joo Lee ◽

Soo-Geun Wang ◽

...

Keyword(s):

Lymph Node ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Predictive Factors ◽

Lymph Node Metastases ◽

Cervical Lymph Node ◽

Nodal Metastasis ◽

Papillary Thyroid ◽

Cervical Lymph Node Metastases ◽

Node Metastases

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Ablation therapy using a low dose of radioiodine may be sufficient in low- to intermediate-risk patients with follicular variant papillary thyroid carcinoma

Journal of International Medical Research ◽

10.1177/0300060520966491 ◽

2020 ◽

Vol 48 (11) ◽

pp. 030006052096649

Author(s):

Fuxin Li ◽

Wei Li ◽

Katherine D. Gray ◽

Rasa Zarnegar ◽

Dan Wang ◽

...

Keyword(s):

Lymph Node ◽

Papillary Thyroid Carcinoma ◽

Local Recurrence ◽

Thyroid Carcinoma ◽

Low Dose ◽

High Dose ◽

Intermediate Risk ◽

Papillary Thyroid ◽

Follicular Variant ◽

Remnant Ablation

Objectives Follicular variant papillary thyroid carcinoma (FVPTC) is treated similarly to classical variant papillary thyroid carcinoma (cPTC). However, FVPTC has unique tumour features and behaviours. We investigated whether a low dose of radioiodine was as effective as a high dose for remnant ablation in patients with FVPTC and evaluated the recurrence of low-intermediate risk FVPTC. Methods Data from cPTC and FVPTC patients treated with I-131 from 2004 to 2014 were reviewed. Demographics, tumour behaviour, lymph node metastasis, and local recurrence data were compared between FVPTC and cPTC patients. Then, low-intermediate risk FVPTC patients were divided into low, intermediate, and high I-131 dose groups, and postoperative I-131 activities were analysed to evaluate the effectiveness of I-131 therapy for thyroid remnant ablation. Results In total, 799 cases of FVPTC (n = 168) and cPTC (n = 631) treated with I-131 were identified. Patients with FVPTC had a larger primary nodule size than cPTC, but lymph node metastases and local recurrence were more prevalent in cPTC than in FVPTC. For the low-, intermediate-, and high-dose groups, success rates of ablation did not differ (82.0%, 80%, and 81.3%, respectively). Conclusion FVPTC differs from cPTC in behaviour. Low-dose ablation may be sufficient in FVPTC patients with low-intermediate disease risk.

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