Primary Hypothyroidism and Essential Hypernatremia in a Patient With Histiocytosis X

C., J. T.; Lam, Karen Siu Ling; Wang, C.; Yeung, Raymond W.; Ho, Faith C. S.

doi:10.1111/j.1445-5994.1985.tb02742.x

Cited by 14 publications

(9 citation statements)

References 7 publications

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“…The diagnosis of thyroidal malignant histiocytosis of Langerhans' cell type, however, was not made until pathological examination of the surgical specimen revealed the proliferation of Langerhans' cells in the thyroid, since repeated fine needle aspiration biopsies were interpreted as papillary thyroid carcinoma and failed to confirm the presence of Langerhans' cells in the thyroid. Histiocytes were also not detected by needle aspiration cytology in the case reported by Ma et al (1985). In addition, other investigators have indicated similar difficulty in differentiating between Langerhans' cell histiocytosis of the thyroid and thyroid carcinoma (Coode & Shaikh, 1988;Goldstein & Layfield, 1991;Lai et al, 1992;Ho et al, 1993) or inflammatory disease such as subacute thyroiditis (Lahey et al, 1986) on the basis of analysis of fine needle aspiration biopsy.…”

Section: Discussionmentioning

confidence: 79%

“…Langerhans' cell histiocytosis of the thyroid is an extremely rare disease, and fewer than 20 cases have been reported previously (Whitaker et al, 1971;Teja et al, 1981;Ma et al, 1985;Lahey et al, 1986;Sinisi et al, 1986;Coode & Shaikh, 1988;Goldstein & Layfield, 1991;Gaines et al, 1991;Schofield et al, 1992;Manna et al, 1992;Lai et al, 1992;Ho et al, 1993). Primarily young people (age range 21 months to 36 years) have been affected, and our patient is the oldest recorded, to our knowledge.…”

Section: Discussionmentioning

confidence: 99%

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Thyroid involvement by malignant histiocytosis of Langerhans' cell type

Kitahama

Iitaka

Shimizu

et al. 1996

Clinical Endocrinology

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Involvement of the thyroid gland by Langerhans' cell histiocytosis is quite rare. We describe the case of a 58-year-old man referred for treatment of a progressively enlarging goitre. The trachea was severely stenotic and adjacent structures such as the left carotid vein and the thyroid cartilage were also involved. Central diabetes insipidus and severe combined immunodeficiency were associated. Although fine needle aspiration biopsy of the thyroid was initially interpreted as papillary carcinoma, anaplastic thyroid cancer was suspected. Treatment with prednisolone, doxorubicin and irradiation controlled the tracheal compression. A diagnosis of thyroid Langerhans' cell histiocytosis was finally made on the basis of the presence of Birbeck granules and CD1a and CD4 antigen in the thyroid tumour cells. Furthermore, positive staining for CD68 and lysozyme suggested that the tumour cells may have had the character of phagocytic cells in addition to their dendritic cell nature. This is the first case of thyroid involvement by malignant histiocytosis of Langerhans' cell type with unusual phagocytic markers.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Thyroid involvement by malignant histiocytosis of Langerhans' cell type

Kitahama

Iitaka

Shimizu

et al. 1996

Clinical Endocrinology

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“…So far, to the best of our knowledge, only seven cases have been reported; FNAC was done in only three cases. [2][3][4] Kirchgraber et al 3 reported a case of a 16-year-old male who presented with persistent, diffuse enlargement of the thyroid gland along with a history of a pituitary tumor. FNAC smears showed a large number of LCs, eosinophils and follicular cells.…”

Section: Discussionmentioning

confidence: 99%

“…Solitary involvement of the thyroid by LCH is uncommon, and histology of only a few cases has been reported. 1,2,4,5 Fine needle aspiration cytology (FNAC) of LCH has rarely been described. 2,3 This paper reports the detailed cytologic features of a histology-proved case of LCH of the thyroid.…”

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confidence: 99%

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis of the Thyroid

Dey¹,

Luthra²,

Sheikh³

1999

Acta Cytologica

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“…In one of these cases, a diagnosis of PTC in a background suggestive of LCH was rendered [15]. In the other reported cases of thyroid LCH where FNA was performed, the cytologic findings were misinterpreted as ''atypical follicular epithelial cells'', ''epithelial neoplasm'' and papillary or medullary carcinoma, or were non-diagnostic [6,25]. Therefore, a high index of suspicion is required to correctly diagnose LCH in thyroid FNA specimens.…”

Section: Fine Needle Aspiration and Biopsymentioning

confidence: 99%

Langerhans Cell Histiocytosis: Diagnosis on Thyroid Aspirate and Review of the Literature

Saqi

Ebner

Ausiello

et al. 2015

Head and Neck Pathol

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Thyroid gland involvement by Langerhans cell histiocytosis is extremely rare. A 35-year-old woman with a history of a suprasellar mass previously diagnosed as a ganglioglioma and complicated by diabetes insipidus, hypogonadotropic hypogonadism, and central hypothyroidism presented with acute onset of neck enlargement. On ultrasound examination, almost the entire thyroid appeared replaced by abnormal lobulated hypoechoic tissue with increased vascularity. Fine needle aspiration (FNA) of the thyroid was performed and revealed singly scattered and loosely cohesive large cells with abundant cytoplasm, including some with irregular nuclear contours and nuclear grooves. No thyroid follicular cells were noted. Based on the cytomorphologic findings and ancillary studies (immunohistochemistry and flow cytometry analysis) a cytological diagnosis of ''positive for neoplastic cells'' with features suggestive of monocytic/histiocytic origin, possibly Langerhans cell histiocytosis (LCH) was rendered. Following FNA, the patient underwent an incisional thyroid biopsy that confirmed the cytological impression of LCH. In light of the new diagnosis of LCH, the prior suprasellar mass biopsy slides were re-reviewed and rare cells suspicious for LCH were observed.Appropriate treatment for systemic LCH was initiated successfully. This case demonstrates that the presence of enlarged and loosely cohesive cells, especially those with irregular nuclear contours, in thyroid FNA specimens should raise suspicion for LCH. The diagnosis of LCH in FNA specimens is challenging. Additional material should be allocated for ancillary studies to confirm the morphological impression. In our case, not only was the thyroid FNA crucial in diagnosing LCH, but instrumental in initiating a thorough diagnostic work-up for multisystem involvement and thus unmasking the true etiology of the patient's suprasellar mass and associated endocrinopathies.Keywords Thyroid Á Langerhans cell histiocytosis Á Fine needle aspiration Á Cytology Á Cytopathology Clinical PresentationA 35-year-old woman with a history of a suprasellar mass, previously diagnosed as a ganglioglioma and complicated by diabetes insipidus (DI), hypogonadotropic hypogonadism, and central hypothyroidism, presented with acute onset of neck enlargement. On physical exam, she appeared euthyroid, and a bilaterally enlarged soft, nontender thyroid of about 60 g was palpated. Radiographic FeaturesOn thyroid ultrasound, the right lobe measured 7.3 9 2.9 9 3.4 cm, and the left lobe measured 5.8 9 2.3 9 2.5 cm; replacement of almost the entire thyroid with abnormal lobulated hypoechoic tissue with increased vascularity was identified (Fig. 1a, b). The rate of growth and the ultrasound

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Primary Hypothyroidism and Essential Hypernatremia in a Patient With Histiocytosis X

Cited by 14 publications

References 7 publications

Thyroid involvement by malignant histiocytosis of Langerhans' cell type

Thyroid involvement by malignant histiocytosis of Langerhans' cell type

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis of the Thyroid

Langerhans Cell Histiocytosis: Diagnosis on Thyroid Aspirate and Review of the Literature

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