1/366. Hurthle cell carcinoma of the thyroid gland with extensive tumor necrosis: a case report.Hurthle cell neoplasm of the thyroid gland is rarely associated with tumor necrosis. We report a case of Hurthle cell carcinoma of the thyroid gland with extensive necrosis. An 82-year-old man had had a right neck mass for more than 10 years. Approximately two to three weeks before he was hospitalized, this neck mass became progressively enlarged. An 131I scan could not demonstrate the right lobe of the thyroid gland, while the contralateral lobe was unremarkable. A 99mTc-sestamibi scan showed increased uptake on the lesion side. Fine needle aspiration cytology showed necrosis with macrophages in the initial aspirate, and the secondary aspirate appeared suspicious for a Hurthle cell tumor. The patient had a total thyroidectomy, and the pathology proved to be Hurthle cell carcinoma with tumor necrosis.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
2/366. Thyroid autonomy (Plummer's disease) with contralateral malignancy--mere coincidence?A patient with an autonomously functioning nodule in the left lobe and a papillary carcinoma in the right lobe of the thyroid gland is described. Some evidence suggests the association to be more than coincidental.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
3/366. An unusual case of benign thyroid tumour consisting of epithelial and nonepithelial components.An encapsulated tumour consisting of follicular epithelial cells, fat-laden round cells and spindle cells was found in the right lobe of the thyroid gland of a 66-year-old woman. The follicular epithelial cells had oxyphilic cytoplasm in which numerous mitochondria were densely packed. The fat-laden round cells were indistinguishable from mature fat cells by light microscopy. However, they were immunohistochemically negative for S-100 protein and epithelial markers, and lacked a continuous basement membrane. The spindle cells embedded in the collagenous matrix possessed well-developed rough endoplasmic reticulum, most of which contained variably sized, non-membrane-bound lipid droplets. Bundles of thin filaments were occasionally observed in the cytoplasm. Some spindle cells were immunoreactive for PCNA and alpha-smooth muscle actin. There was no striking nuclear atypia of the tumour cells and no capsular or vascular invasion by these components. The tumour can be classified as a benign mixed tumour.- - - - - - - - - - ranking = 0.5keywords = lobe (Clic here for more details about this article) |
4/366. Parasitic nodule of the thyroid in a patient with Graves' disease.We report a case of a parasitic nodule of the thyroid in a patient with Graves' disease, which mimicked a lymph node metastasis from a primary occult thyroid carcinoma. The patient was a 67-year-old Japanese woman with a past history of subtotal thyroidectomy for Graves' disease, who was referred to our hospital because of a right cervical mass. A lymph node-like lesion measuring 1.5 cm in diameter was palpable, distinct from the remnant of the right thyroid lobe. Thyroid scintigraphy using 123I-Na revealed a hot lesion at the upper lateral portion of the right thyroid lobe, and this was resected. Microscopically, the mass showed thyroid follicles with lymphocytic infiltration and lymphoid follicles. Clear ground glass nuclei, nuclear grooving and intranuclear inclusions were not observed. No morphological evidence of the lymph node was found in the mass by reticulin staining. Parasitic nodules of the thyroid in patients with Graves' disease may mimic a metastatic carcinoma of the thyroid.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
5/366. Occult sclerosing carcinoma of the thyroid.A case of occult sclerosing thyroid carcinoma is reported. The primary requirement for diagnosis is that the cancer is less than 1.5 cm in diameter. In addition, a fibrosing component with varying degrees of sclerosis is present. Lymph node metastases are frequent and may appear as benign thyroid follicles. Occasional direct invasion or vascular invasion may occur. Distant metastases were not reported in the series reviewed. Adequate therapy would seem to be total thyroidectomy of the involved lobe and radical subtotal thyroidectomy of the opposite lobe with excision of all enlarged or involved lymph nodes.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
6/366. Maltoma of the thyroid in a man with Hashimoto's thyroiditis.We report the case of a 42-yr-old man with primary thyroid lymphoma arising from mucosa-associated lymphoid tissue (MALT-lymphoma, maltoma). The patient underwent a hemithyroidectomy for a growing mass in the right lobe of the thyroid while being treated with 1-thyroxine for Hashimoto's thyroiditis. The clinical diagnosis of Hashimoto's disease was confirmed by aspiration biopsy of the mass during the course of L-thyroxine treatment. Postoperatively, histology showed atypical lymphoproliferative infiltrates suspicious of low-grade non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue-type, coexisting with a reactive process typical of chronic lymphocytic thyroiditis. immunophenotyping showed a mixed B- and T-lymphocyte population, which was nondiagnostic. However, Southern blot analysis revealed a clonal rearrangement of the Ig heavy chain gene. This case demonstrates that cytology or histology may not distinguish between reactive or low-grade lymphomatous thyroid processes. The use of molecular technique was essential to prove clonality and the presence of lymphoma.- - - - - - - - - - ranking = 0.5keywords = lobe (Clic here for more details about this article) |
7/366. Thyroid lung metastasis diagnosed 47 years after thyroidectomy.A 75-year-old woman underwent excision of a middle lobe lung nodule that contained a separate, isolated focus of metastatic papillary thyroid carcinoma. A thyroid lobectomy for papillary cancer had been performed 47 years earlier. This interval is believed to be the longest time from initial diagnosis to identification of distant lung metastasis reported. The pertinent published reports are reviewed and methods of surveillance discussed.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
8/366. Mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid: report of a case.The patient was 59-year-old Japanese woman who presented with a neck swelling. ultrasonography and computed tomography demonstrated a round tumor in the thyroid right lobe measuring 2.5 x 1.5 cm in size. A right hemithyroidectomy with lymph node dissection was performed. Histopathological findings demonstrated low-grade B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) associated papillary microcarcinoma. A previous report showed an excellent prognosis of MALT lymphoma of the thyroid without capsular invasion or lymph node involvement. We also describe the concept of MALT lymphoma as a primary lesion in which lymphoid tissue is not present in the normal state.- - - - - - - - - - ranking = 0.5keywords = lobe (Clic here for more details about this article) |
9/366. Cribriform-morular variant of papillary carcinoma: a distinctive variant representing the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma?We describe herein four cases of an unusual sporadic thyroid tumor that shares the morphologic features of a distinctive follicular cell neoplasm previously proposed as a feasible indicator of familial adenomatous polyposis. We also review five other similar cases reported in the literature. All of the nine patients were young women, aged 16 to 30 years. Grossly, the neoplasms measured 1.5 to 5.6 cm; they were solid and solitary, except one case, which showed two tumor nodules, one in each lobe. Histologically, the lesions were encapsulated, and they exhibited an intricate blending of cribriform, follicular, papillary, trabecular, and solid patterns of growth, with morular (squamoid) areas. Cribriform structures were prominent, being formed by anastomosing bars and arches of cells in the absence of intervening fibrovascular stroma. Follicular areas were usually devoid of colloid, and the papillae were lined by columnar cells. There were focal areas of trabecular arrangement reminiscent of hyalinizing trabecular adenoma. The tumor cells were cuboidal or tall, with frequent nuclear pseudostratification and abundant eosinophilic-to-oxyphilic cytoplasm. The nuclei were usually hyperchromatic, but nuclear grooves, pale or clear nuclei, and intranuclear cytoplasmic inclusions were variably present. Morules with peculiar nuclear clearing caused by biotin accumulation were scattered in the tumors. Vascular and/or capsular invasion were noted in all of the cases except one, and lymph node metastasis was found in two cases. Immunohistochemical stains showed reactivity for thyroglobulin, epithelial membrane antigen, cytokeratins (including 34betaE12), vimentin, estrogen and progesterone receptors, bcl-2, and Rb proteins. Follow-up in seven cases showed that all of the patients were alive with no evidence of disease at 1 to 13 years after diagnosis. Thus, the behavior of this variant seems to be similar to that of conventional papillary carcinoma Because of the distinctive histologic features, we propose naming this tumor the cribriform-morular variant of papillary carcinoma.- - - - - - - - - - ranking = 0.5keywords = lobe (Clic here for more details about this article) |
10/366. A peculiar factor viii-related antigen staining of an oxyphilic cell nodule within an intrathyroidal parathyroid adenoma.A case of intrathyroidal parathyroid adenoma, which was found in the lower portion of the right thyroid lobe, is presented. The nodule in this lesion was composed of oxyphilic cells. In order to verify a possible vascular invasion, immunohistochemical study with factor viii-related antigen/von willebrand factor, which is known to be synthesized by the endothelial cells and stored in weibel-palade bodies, and ulex europaeus lectin 1 were applied. It was interesting to find positivity for factor viii-related antigen and ulex europaeus lectin I strictly confined in the nodule of oxyphil cells, which are known to have large numbers of mitochondria. This led to investigating similar immunoreactions in different lesions of oxyphilic cells with several other markers. The possible cross-reaction between weibel-palade bodies and mitochondria deserves further detailed research.- - - - - - - - - - ranking = 0.5keywords = lobe (Clic here for more details about this article) |
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