scholarly journals Adenoma thyroid with supraclavicular tuberculous lymphadenitis Masquerading as malignancy thyroid with Metastasis - Diagnostic dilemma

2020 ◽  
Vol 8 (2) ◽  
pp. 106-108
Author(s):  
Nagendra Mahendra ◽  
Abhijeet Ingle ◽  
Dharmendra kumar borad ◽  
Majed Abdul Basit Momin
Keyword(s):  
Lymph Node ◽  
Clinical Examination ◽  
Follicular Adenoma ◽  
Clinical Importance ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Supraclavicular Lymph Node ◽  
Diagnostic Dilemma ◽  
Thyroid Swelling

Thyroid swelling or goitre is one of the commonest presentations among female patients more than males attending ENT out patients. The clinical importance of thyroid swelling is related to evaluating their functional status and assess,whether it is benign,malignant ,hypo or hyper active.Even if benign should look for pressure symptoms which justifies surgery.Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis.Coexistence of thyroid swelling with supraclavicular lymph node mimicking malignancy with metastatic deposit is unusual and always to be evaluated. We report a case of a 45-year female,who on outside initial evaluation was diagnosed as follicular carcinoma of thyroid. However clinical examination revealed a palpable supraclavicular lymph node. Thus subjected to a repeat FNA (fine needle aspiration) from thyroid which revealed benign thyroid follicular adenoma and FNA from supraclavicular lymph node revealed tuberculous lymphadenitis, which was further confirmed by histological sections post operatively. This case emphasizes the need for thorough clinical examination and utility of image guided FNA to rule out the biological nature of these lesions.

The Thyroid Gland: Recurring Problems in Histologic and Cytologic Evaluation

2008 ◽  
Vol 132 (4) ◽  
pp. 622-632
Author(s):  
William C. Faquin
Keyword(s):  
Thyroid Gland ◽  
Follicular Adenoma ◽  
Endocrine System ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Poorly Differentiated Carcinoma ◽  
Different Types ◽  
Poorly Differentiated ◽  
Common Malignancy

Abstract Nodules of the thyroid gland are frequently encountered, occurring in up to 7% of the population, and although most of these nodules are benign, carcinomas of the thyroid gland are the most common malignancy of the endocrine system. Although the different types of thyroid carcinoma are few, a wide variety of recurring problems exists in both their histologic and cytologic evaluation. Here, I will review a selected group of problematic areas, including unusual histologic variants of follicular adenoma, criteria for diagnosing minimally invasive follicular carcinoma, the use of fine-needle aspiration as a screening test for follicular neoplasia, challenging variants of papillary carcinoma, and features of poorly differentiated carcinoma.

scholarly journals Diagnosis of Tuberculous Lymphadenitis from Fine Needle Aspirate by PCR

2017 ◽  
Vol 8 (1) ◽  
pp. 2-6
Author(s):  
Hasina Akhter ◽  
Zakir Hossain Habib ◽  
Imtiaz Ahmed ◽  
Hafiza Akhter ◽  
Abdullah Yusuf ◽  
...  
Keyword(s):  
Lymph Node ◽  
Predictive Value ◽  
Needle Aspiration ◽  
Lymph Node Involvement ◽  
Tuberculous Lymphadenitis ◽  
Fine Needle Aspirate ◽  
Fine Needle ◽  
Medical College ◽  
Lymph Node Enlargement ◽  
Node Involvement

Lymph node involvement is the commonest form of extra pulmonary tuberculosis (EPTB). This study was undertaken to evaluate the role of PCR using IS6110 as a target for Mycobacterium tuberculosis complex in the diagnosis of tuberculous lymphadenitis (TB-L) and was done in Microbiology department of Sir Salimullah Medical College from July 2009 to June 2010. Fine needle aspiration was performed on 107 patients with a clinical suspicion of tuberculous lymphadenitis from different hospitals of Dhaka City Corporation area. All the aspirated samples were subjected to culture and PCR for M.tuberculosis. Out of 107 patients with lymphadenopathy most of the patients (85.9%) had cervical lymph node enlargement followed by axillary groups (12.1%) and inguinal groups (1.9%). Out of 107 cases, 65 (60.7%) were PCR positive and 56 (52.3%) were culture positive. Among 51 (47.7%) culture negative cases 9 (17.65) were PCR positive. Sensitivity of PCR was 100% and specificity was 82.4%.The positive predictive value (PPV), negative predictive value (NPV) and accuracy of PCR were 86.2%, 100% and 91.6% respectively. PCR is the most sensitive in the detection of M.tuberculosis in fine needle aspirate and could be useful technique in establishing the diagnosis of tuberculous lymphadenitis.

scholarly journals Caseating Tuberculous Lymphadenitis- A Case Report

2021 ◽  
pp. 37-40
Author(s):  
Mayur B. Wanjari ◽  
Deeplata Mendhe ◽  
Pratibha Wankhede ◽  
Sagar Alwadkar
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Granulomatous Inflammation ◽  
Neck Region ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Submandibular Region ◽  
Hiv Test ◽  
Painful Sensation ◽  
Loss Of Appetite

Introduction: Tuberculosis lymphadenitis (or tuberculous adenitis) is the most common type of infection with tuberculosis that occurs outside of the respiratory system. Tuberculosis lymphadenitis is a chronic condition caused by Mycobacterium tuberculosis in the granulomatous inflammation of the lymph node caused by caseated necrosis. The number of people who contact tuberculosis is estimated at 8 million per year, and about 3 million people die from tuberculosis in the world. Presentation of Case: In this case report we delineate the case of a female patient, 26-year-old, she had some pain and lymph node swelling in her right submandibular region since from 4 months and was diagnosed as right Caseating Tuberculous Lymphadenitis, associated with the cervical (neck) region, who was immunocompetent and HIV test negative, with a history of recurring fever, weight loss, loss of appetite for the last 4 months. On physical examination, she had swelling approximately 3×3 cm in the right submandibular region and a hard mass and painful sensation were noticed in her right submandibular region. On Fine needle aspiration cytology of submandibular lymph node reveals Caseating Tuberculous Lymphadenitis. this is extremely rare in immunocompetent individuals.

scholarly journals Malignancy in Clinically Non-toxic Multinodular Goiter

2021 ◽  
Vol 10 (1-2) ◽  
pp. 84-88
Author(s):  
Mohd Shahjahan Ali ◽  
Md Habibullah Sarkar ◽  
Syeda Momena Hossain
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Histopathological Examination ◽  
Follicular Adenoma ◽  
Cervical Lymphadenopathy ◽  
Follicular Carcinoma ◽  
Chronic Thyroiditis ◽  
College Hospital ◽  
Toxic Multinodular Goiter ◽  
Thyroid Swelling

Objective: Goiter is a common form of thyroid swelling among population living in areas of iodine deficiency. Of the goiters, non-toxic multinodular goiter (MNG) is the most common and benign form of thyroid disease. However, studies have shown that long-standing MNGs may harbour malignancy. The present study was, therefore, undertaken to ascertain the prevalence of malignancy in clinically diagnosed non-toxic MNGs. Methods: This cross-sectional study was conducted in the Department of Surgery (all four-units) and ENT Department, Rajshahi Medical College Hospital, Rajshahi from July 2007 to June 2008 on 100 patients of clinically non-toxic MNG who underwent thyroid surgery. Biopsy materials were taken from the excised nodules and were sent for histopathological examination to see what proportion of them harboured malignancy. Result: The findings of the study showed that 40% of patients were 30-40 years old with mean age of the patients being 35.5 ± 10.1 (range: 14-75) years. Majority (87%) of the patients was female. Half of the patients with non-toxic MNGs had a history of thyroid swelling for 1-5 years and the rest half for > 5 years with median duration of illness being 5.5 years (range: 1-30 years). Of the 100 patients 4% had stridor and 6% dyspnoea; dysphagia and cervical lymphadenopathy each was 6%. Nearly 60% of the patients had goiter of size 15 sq-cm or below. Sub-total thyroidectomy was the most common operation performed (33%) followed by right hemi-thyroidectomy (24%), near total thyroidectomy (20%), left hemi-thyroidectomy (18%) and total thyroidectomy (5%). Histopathological examination of resected specimens revealed that 15% of the MNGs had malignancy with papillary to follicular carcinoma ratio being 4:1. Histopathological typing showed that 79% was simple MNGs, 4% follicular adenoma, 12% papillary carcinoma, 3% follicular carcinoma and 2% chronic thyroiditis. Neither age nor sex was found to be associated with presence of malignancies in MNGs (p = 0.865 and p = 0.647 respectively). The goiter-size was also not associated with presence of malignancies (p = 0.691). However, the mean duration of thyroid swelling in patients who had malignancy was much higher (8.5 years) than that in patients who did not haveany malignancy (5.7 years) (p = 0.024). Conclusion: The study concluded that a small proportion of long-standing non-toxic MNGs may turn into malignancy. Therefore, routine operative treatment without confirming that the cases are malignant does not seem to be justified. Ibrahim Card Med J 2020; 10 (1&2): 84-88

scholarly journals Fine Needle Aspiration of a Metastatic Germ Cell Tumor to Supraclavicular Lymph Node

2014 ◽  
Vol 45 (2) ◽  
pp. e72-e72
Author(s):  
Xiu Yang ◽  
Adam Cole ◽  
Antonio Cajigas ◽  
Samer Khadher
Keyword(s):  
Lymph Node ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Cell Tumor ◽  
Supraclavicular Lymph Node ◽  
Fine Needle

scholarly journals Polymerase Chain Reaction-Based Microsatellite Polymorphism Analysis of Follicular and Hürthle Cell Neoplasms of the Thyroid1

1998 ◽  
Vol 83 (6) ◽  
pp. 2036-2042
Author(s):  
Dorry L. Segev ◽  
Motoyasu Saji ◽  
Grace S. Phillips ◽  
William H. Westra ◽  
Yumi Takiyama ◽  
...  
Keyword(s):  
Surgical Management ◽  
Frozen Section ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
Microsatellite Polymorphism ◽  
Polymorphism Analysis ◽  
Exact Test ◽  
Allelic Alteration

Follicular and Hürthle cell carcinomas of the thyroid cannot be differentiated from adenomas by either preoperative fine needle aspiration or intraoperative frozen section examination, and yet there exist potentially significant differences in the recommended surgical management. We examined, by PCR-based microsatellite polymorphism analysis, DNA obtained from 83 thyroid neoplasms [22 follicular adenomas, 29 follicular carcinomas, 20 Hürthle cell adenomas (HA), and 12 Hürthle cell carcinomas (HC)] to determine whether a pattern of allelic alteration exists that could help distinguish benign from malignant lesions. Alterations were found in only 7.5% of informative PCR reactions from follicular neoplasms, whereas they were found in 23.3% of reactions from Hürthle cell neoplasms. Although there were no significant differences between follicular adenoma and follicular carcinoma, HC demonstrated a significantly greater percentage of allelic alteration than HA on chromosomal arms 1q (P < 0.001) and 2p (P < 0.05) by Fisher’s exact test. The documentation of an alteration on either 1q or 2p was 100% sensitive and 65% specific in the detection of HC (P < 0.0005, by McNemar’s test). In conclusion, PCR-based microsatellite polymorphism analysis may be a useful technique in distinguishing HC from HA. Potentially, the application of this technique to aspirated material may allow this distinction preoperatively and thus facilitate more optimal surgical management. Consistent regions of allelic alteration may also indicate the locations of critical genes, such as tumor suppressor genes or oncogenes, that are important in the progression from adenoma to carcinoma. Finally, this study demonstrates that Hürthle cell neoplasms, now considered variants of follicular neoplasms, differ significantly from follicular neoplasms on a molecular level.

Paediatric neck masses – a diagnostic dilemma

1997 ◽  
Vol 111 (6) ◽  
pp. 541-545 ◽  
Author(s):  
A. A. P. Connolly ◽  
K. MacKenzie
Keyword(s):  
Lymph Node ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Malignant Tumours ◽  
Diagnostic Dilemma ◽  
Neck Masses ◽  
The Mean ◽  
Needle Aspiration Cytology ◽  
Sick Children ◽  
Reactive Hyperplasia

AbstractThree hundred and sixty children who had a head and neck mass excised during 1987 to 1992 at the Royal Hospital for Sick Children, Glasgow were studied. There were 210 males and 150 females with a mean age of 60.7 months (0.5 to 198 months). Pilomatrixomata/sebaceous cysts (34 per cent), thyroglossal cysts (13 per cent), branchial remnants (nine per cent) and dermoids (nine per cent) accounted for almost twothirds of the 264 non-lymphadenomatous benign lesions excised. Ninety-three lymphadenopathy masses consisted of 60 with reactive hyperplasia, 21 with Mycobacterium infection and 12 lymphomas. There were three solid malignant tumours, two were rhabdomyosarcomata and one disseminated round cell tumour. The correlation between clinical diagnosis and histopathology of benign non-lymph node masses and solid tumours was 90 per cent and 100 per cent respectively, in benign lymph nodes, 66 per cent, but was poor in differentiating lymph node content. The mean time from presentation of a swelling to its excision was almost a year and the mean in-patient stay for excision of a mass was almost five days. The role of fine needle aspiration cytology (FNAC) in arriving at a diagnosis and reducing patient morbidity is discussed.

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