A Six-Year-Old Boy with a Suspicious Thyroid Nodule: Intrathyroidal Thymic Tissue

Hernández-Cassis, Carlos; Poniecka, Anna W.; Vogel, Claudia K.; McKenzie, J. M.

doi:10.1089/thy.2007.0262

Cited by 30 publications

(36 citation statements)

References 33 publications

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“…In an 11 year-old girl, a 5 year-old boy and a 6 year-old girl (Patients 1, 8 and 9), the lesion got slightly smaller. In a female patient with bilateral IET (Patient 13), the lesion on the right was slightly smaller by age 10, whereas the le- 1 Longitudinal x AP x transverse; if only 2 dimensions are given transverse x AP; 2 Respectively; side, craniocaudal location as described in methods, anteroposterior location as described in methods; 3 All lesions were hypoechoic compared to surrounding thyroid, had well defined borders and were identical in sonographic appearance to normal thymus of the patient; 4 Underwent fine-needle aspiration; cytologic diagnosis was IET. The echogenicity of the lesion increased during follow-up; 3 Underwent hemithyroidectomy; pathologic diagnosis was IET; 6 Lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

“…Sonographic differential diagnosis also includes parathyroid adenomas and nodular type of Hashimoto thyroiditis [4]. Further complicating the matter is that, since the aspirate from IET would contain lymphoid cells, the cytologist might evaluate it as Hashimoto's thyroiditis or even thyroid lymphoma [3,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…However, 20-73% of nodules found in children are malignant [3]. This makes essential a proper sonographic evaluation of all the nodules and solid knowledge about the differential diagnoses.…”

Section: Introductionmentioning

confidence: 99%

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Intrathyroidal ectopic thymus in children: a sonographic survey

et al. 2017

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Aims: Intrathyroidal ectopic thymus (IET) is being increasingly reported in the radiology literature. Most of the reports are of individual cases or small series and prevalence and natural course of the pathology is not well known. The purpose of this study is to establish the prevalence of IET in children and report long term follow-up results.Material and methods: In 180 children who were examined by ultrasound (US) for other reasons, 7 patients were indentified with IET. Together with the other seven children who were already under follow-up for IET (diagnosed using US criteria), these 14 patients were followed up with US for 30 months. Size, shape, location, echotexture and internal echoes of the lesions were evaluated.Results: There were 16 lesions in 14 children. The most common appearance was a fusiform hypoechoic lesion, with punctate and linear internal echoes and well-defined but slightly irregular borders located posteriorly in the lower thirds of the thyroid. In follow-up, there were no changes in echotexture, shape or border. In 3 patients, the lesion became slightly smaller, in a 10-year-old boy slightly larger, and in an 11-year old boy the lesion disappeared. In a patient with bilateral lesions, one lesion slightly decreased in size.Conclusions: IET in children may be more common than thought. Its growth reflects that of a normal thymus. Awareness of this entity is important in order not to misdiagnose them, especially as papillary cancer, and to prevent unnecessary interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intrathyroidal ectopic thymus in children: a sonographic survey

et al. 2017

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“…The authors also reported an additional patient who underwent thyroid lobectomy because the ectopic thymus was thought to be a tumor [16]. Ectopic intrathyroidal thymus rarely gives rise to symptoms [1,2,3,4,5,6,7]. In the majority of previously reported cases (table 2) the diagnosis of ectopic thymus was made after surgery and/or fine-needle aspiration biopsy because the thymic inclusion was thought to be a thyroid nodule.…”

Section: Discussionmentioning

confidence: 99%

“…When mistaken for a thyroid nodule, the finding of intrathyroidal ectopic thymic tissue may lead to surgery and/or invasive diagnostic procedures in children [1,2,3,4,5,6,7]. However, the thymus has a unique appearance on ultrasonography and ectopic thymus parenchyma can be easily identified [8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

Ectopic Intrathyroidal Thymus in Children: A Long-Term Follow-Up Study

et al. 2010

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Background: Ectopic intrathyroidal thymus has recently been reported in children as a cause of surgery and/or invasive diagnostic procedures when mistaken for a thyroid nodule. Thymus has a unique appearance at ultrasound (US). Methods: We report a follow-up study (mean 34 months, range 6–84) performed by US on 9 children (5 females) with a mean age of 6.3 ± 3.2 years with intrathyroidal thymic inclusions diagnosed by US as ‘incidentalomas’. None has palpable nodules. Results: Intrathyroidal thymic inclusions appeared on US as a hypoechoic area, with regular linear or punctuate internal hyperechoic echoes. The 2 oldest patients (13 and 17 years) showed a regression in both size and hypoechogenicity of thymic inclusions over time – reflecting the normal thymic involution with advancing age. Conclusions: Indeed, the lack of progression seen in our 9 patients over a mean time of 34 months confirmed the substantially benign and self-limited nature of this process. The increasing use of thyroid ultrasonography in children may result in an increased detection of intrathyroidal thymic inclusions – an embryologic anomaly that should be considered in the differential diagnosis of thyroid nodules in children and adolescents.

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