A Case of Malignant Thymoma Mimicking Thyroid Carcinoma: A Pitfall in Fine-needle Aspiration

Matsuura, Bunzo; Tokunaga, Hitoo; Miyake, Teruki; Utsunomiya, Sachiko; Minami, Hisaka; Onji, Morikazu

doi:10.1507/endocrj.51.237

Cited by 12 publications

(18 citation statements)

References 17 publications

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“…papillary, follicular and medullary carcinoma). Typically, papillary or follicular differentiation is not seen [11], but pathologically, squamous cell carcinoma, papillary or medullary thy- roid carcinoma with squamous differentiation and anaplastic thyroid cancer must be taken into consideration [2,4,12]. Even if cytology shows characteristic cells (e.g., squamoid cells with eosinophilic cytoplasm, oval nuclei with small distinct nucleoli), morphology alone may not be sufficient for a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Aggressive Thyroid Carcinoma Showing Thymic-Like Differentiation (Castle): Case Report and Review of the Literature

et al. 2008

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Abstract. Carcinoma showing thymic-like differentiation (CASTLE) is a rare tumour of the thyroid, which arises from ectopic thymic tissue or remnants of branchial pouches. A systematic review of English literature evidences less than thirty cases; from them, it clearly appears that CASTLE is considered an indolent slow-growing neoplasia even when lymph nodes metastasis are present. We describe a case of very aggressive CASTLE, which showed seeding along fine needle aspiration tract.

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Section: Discussionmentioning

confidence: 99%

Aggressive Thyroid Carcinoma Showing Thymic-Like Differentiation (Castle): Case Report and Review of the Literature

et al. 2008

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“…The tumour commonly presents as a palpable neck mass that can be easily approached by fine needle aspiration (FNA). There are 13 cases of ectopic cervical thymomas described by aspiration smear [1,2,3,4,5,6,7,8,9,10,11,12,13]. Because of the unusual location and rare incidence, the cytologic features of ectopic cervical thymomas are often misinterpreted as thyroiditis, thyroid malignancy, metastatic tumour to lymph nodes and even soft tissue tumours [1,2,3,4,5,7,8,9,10,11,12,13,14].…”

Section: Introductionmentioning

confidence: 99%

Ectopic Thymoma Can Mimic Benign and Malignant Thyroid Lesions on Fine Needle Aspiration Cytology: A Case Report and Literature Review

Taweevisit

Sampatanukul²,

Thorner³

2013

Acta Cytologica

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Background: Ectopic cervical thymomas are rare and there are few descriptions of the cytologic findings based on fine needle aspiration. Their appearances can be misinterpreted as either benign or malignant lesions of the thyroid. The authors report such a case occurring in a patient with Sotos syndrome, a genetic disorder characterized by somatic overgrowth and cognitive impairment. Case Report: The patient developed a neck mass that was examined first by fine needle aspiration and then by pathologic examination of the resected specimen. On fine needle aspiration, a diagnosis of papillary carcinoma of the thyroid was favoured, based on the presence of large cohesive sheets of anastomosing papillary tissue fragments with fibrovascular cores. Pathologic examination of the resection specimen showed a thymoma, subtype B3. The cytologic findings correlated with the presence of nuclear palisading of tumour cells around perivascular spaces. Conclusion: To the best of our knowledge, this histologic subtype of thymoma has never been reported in ectopic cervical thymic tissue, nor these particular cytologic findings that can lead to an erroneous diagnosis of thyroid carcinoma. Moreover, this is the first description of thymoma in association with Sotos syndrome.

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“…Taweevisit et al (4) compiled the details of all 14 cases in a literature review. The initial cytological diagnoses included Hashimoto thyroiditis, lymphocytic thyroiditis, papillary and medullary carcinomas, malignant lymphoma of the thyroid and various types of soft-tissue tumor (3)(4)(5)7,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). According to the 2004 WHO classification system, the thymoma subtypes were predominantly type AB and type B1, as well as two type A thymomas, one type B2 thymoma and one type B3 thymoma (5,6).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…These tumors were misdiagnosed as primary thyroid carcinoma, metastatic carcinoma and various types of soft-tissue tumor (5,11,13,14,16). In one case, cohesive epithelial cell clusters with rare intranuclear inclusions were observed, resulting in the misdiagnosis as a (16). Identifying typical cytological features, such as papillary architecture and nuclear changes, including powdery chromatin, nuclear grooves and the psammoma bodies observed in papillary thyroid carcinoma, which are absent from ectopic thymoma, may be useful for forming a differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Aspiration cytology of an ectopic cervical thymoma misinterpreted as a lymphoproliferative lesion of the thyroid: A case report

Lee

Wang

2015

Oncology Letters

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Abstract. Ectopic cervical thymoma is a rare tumor that originates from ectopic thymic tissue trapped during the migration of the embryonic thymus. To the best of our knowledge, only 14 cases of ectopic cervical thymoma, which include descriptions of the cytological features based on fine-needle aspiration (FNA), have been reported thus far. The current study describes the case of a 52-year-old male presenting with an enlarging anterior neck mass that been apparent for a number of years and was now accompanied by shortness of breath. FNA cytology revealed large numbers of small lymphocytes admixed with rare groups of large, polygonal cells that were interpreted to be reactive lymphocytes or possible follicular dendritic cells. However, no definite follicular or Hürthle cells were identified. Therefore, the overall cytological features were misinterpreted as a lymphoproliferative lesion. However, subsequent histological analysis of the resected left total lobectomy specimen determined a diagnosis of thymoma, type B1. Thus, awareness of this entity combined with a careful search for thymic epithelial cells may aid in determining a correct diagnosis when FNA is performed for the evaluation of a neck mass.

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A Case of Malignant Thymoma Mimicking Thyroid Carcinoma: A Pitfall in Fine-needle Aspiration

Cited by 12 publications

References 17 publications

Aggressive Thyroid Carcinoma Showing Thymic-Like Differentiation (Castle): Case Report and Review of the Literature

Aggressive Thyroid Carcinoma Showing Thymic-Like Differentiation (Castle): Case Report and Review of the Literature

Ectopic Thymoma Can Mimic Benign and Malignant Thyroid Lesions on Fine Needle Aspiration Cytology: A Case Report and Literature Review

Aspiration cytology of an ectopic cervical thymoma misinterpreted as a lymphoproliferative lesion of the thyroid: A case report

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