Thyroid Langerhans cell histiocytosis and papillary thyroid carcinoma

Abstract

A 27-year-old female, married with two children, presented to our clinic with a 1-year history of thyroid swelling and pressure symptoms on lying backward and bilateral cervical lymphadenopathy. The patient was a known case of panhypopituitarism for 5 years. Comprehensive patient evaluation including FNAC with papillary thyroid cancer result then she underwent total thyroidectomy and bilateral neck dissection and final histologic examination confirmed papillary thyroid carcinoma in the background of lymphocytic thyroiditis, associated with Langerhans cell histiocytosis (LCH). The draining cervical lymph nodes were also involved by LCH and metastatic papillary thyroid carcinoma. Although the association of LCH with papillary thyroid carcinoma in the thyroid has been reported, their co-existence with LCH in the draining lymph nodes is very uncommon.

Challenging diagnosis of two neoplasms, Langerhans cell histiocytosis and papillary thyroid carcinoma, from fine needle aspiration of the thyroid by cell‐block immunocytochemistry and molecular testing for BRAF V600E mutation

“…FNA from thyroid in this patient showed features of PTC. On histopathological examination of the thyroid, there was evidence of LCH in addition to PTC, which was confirmed by immunohistochemistry . Ceyran et al reported a similar case in a 37‐year‐old man who presented with a thyroid swelling and lymphadenopathy.…”

“…Coexistence of LCH and PTC in thyroid is very rare and a few case reports have been documented in literature. Rajab et al reported a similar case in a 27‐year‐old woman who presented with neck swelling and symptoms of hypothyroidism and diabetes insipidus. FNA from thyroid in this patient showed features of PTC.…”

“…Over the next LCH in addition to PTC, which was confirmed by immunohistochemistry. 5 Ceyran et al 6 reported a similar case in a 37-year-old man who presented with a thyroid swelling and lymphadenopathy. He was confirmed on histopathology to have both these entities along with lymph node metastasis.…”

BRAF gene mutations in synchronous papillary thyroid carcinoma and Langerhans cell histiocytosis co-existing in the thyroid gland: a case report and literature review

“…Its association with PTC is also extremely rare, with only few case reports available in the literature [1–8]. Table 1 represents the cases of synchronous papillary thyroid carcinoma and Langerhans cell histiocytosis co-existing in the thyroid gland [1, 2, 7–16]. Herein, we report a case of co-existing PTC and LCH in the thyroid gland with detected BRAF V600E and V600K mutations respectively.…”

New techniques and technologies for the treatment of surgical endocrine diseases

“…Owing to the close international collaboration we are presenting in this issue 12 reports from leading experts in the field focused on selected hot topics in endocrine surgery: intraoperative neural monitoring (IONM) in thyroid surgery (1,2), safety of energy based devices (EBD) for hemostasis in thyroid surgery (3), utility of BRAF V600E mutation for prognostication of papillary thyroid cancer (PTC) recurrence (4), rare cases of PTC associated with thyroid Langerhans cell histiocytosis (5), management of thyroid cancer with tracheal invasion (6), utility of indocyanine green-enhanced fluorescence to assess parathyroid perfusion during thyroidectomy (7), value of iPTH assay for early prognostication of postoperative hypocalcemia (8), risk factors for perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma (9), utility of laparoscopic sleeve gastrectomy (LSG) for the treatment of diabetes mellitus type 2 (10), innovative solutions in bariatric surgery (11), including new endoscopic procedures for diabetes mellitus type 2 and obesity treatment (12).…”