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Anaplastic thyroid carcinoma presenting as bilateral pleural effusion.

Sodhi R, Sindhwani G, Chandra S, Anand D - Lung India (2014)

Bottom Line: Anaplastic thyroid cancer presenting as bilateral malignant pleural effusion is rarely reported.We present a case who presented solely with respiratory symptoms and subsequently found to be having bilateral malignant pleural effusion secondary to anaplastic thyroid cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.

ABSTRACT
Anaplastic thyroid cancer presenting as bilateral malignant pleural effusion is rarely reported. We present a case who presented solely with respiratory symptoms and subsequently found to be having bilateral malignant pleural effusion secondary to anaplastic thyroid cancer.

No MeSH data available.


Related in: MedlinePlus

Computed tomography of chest showing bilateral pleural effusion (right more than left) with pericardial effusion
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Figure 2: Computed tomography of chest showing bilateral pleural effusion (right more than left) with pericardial effusion

Mentions: A 44-year-old, diabetic and hypertensive, nonsmoker female presented with history of progressively increasing dry cough and shortness of breath since 3 months and heaviness in chest since 1 month. She did not give history of fever, night sweats, or weight loss. On physical examination, she was afebrile and tachypneic. A hard-fixed swelling of 2 × 2 cm with normal overlying skin was found in right cervical region, which moved with deglutition. On systemic examination, breath sounds were found to be decreased on right side. Skiagram of chest revealed bilateral pleural effusion (right more than left) [Figure 1]. Her hemogram was normal except a slightly raised total leukocyte count (13,000/mm3). Liver and renal functions were normal. Echocardiography was done which revealed mild pericardial effusion. Computed tomography (CT) of the chest showed bilateral moderate pleural effusion with mild pericardial effusion [Figure 2]. Ultrasonography of the neck revealed a hyperechoic, oval nodule in right lobe of thyroid. Thyroid functions were normal. Fine needle aspiration cytology (FNAC) of thyroid nodule revealed large cells with multinucleation and prominent nucleoli with presence of mitotic figures and absent colloid favoring anaplastic carcinoma [Figure 3]. Diagnostic thoracentesis revealed clear, amber-colored pleural fluid which was exudative in nature with low cell count. It was negative for acid-fast bacilli and bacteria on smear examination. Pleural fluid cytology revealed malignant cells arranged in three-dimensional (3D) ball clusters and groups [Figure 4]. Correlation with pleural fluid cytology revealed that the cells in thyroid FNA and pleural fluid were cytologically same. Pleural fluid thyroglobulin levels were not raised. Radioiodine tracer uptake revealed poor uptake of radiocontrast further confirming anaplastic nature. Consequently, she was diagnosed as anaplastic thyroid carcinoma with metastatic bilateral pleural and pericardial effusion. She was referred to the department of oncology for management.


Anaplastic thyroid carcinoma presenting as bilateral pleural effusion.

Sodhi R, Sindhwani G, Chandra S, Anand D - Lung India (2014)

Computed tomography of chest showing bilateral pleural effusion (right more than left) with pericardial effusion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129600&req=5

Figure 2: Computed tomography of chest showing bilateral pleural effusion (right more than left) with pericardial effusion
Mentions: A 44-year-old, diabetic and hypertensive, nonsmoker female presented with history of progressively increasing dry cough and shortness of breath since 3 months and heaviness in chest since 1 month. She did not give history of fever, night sweats, or weight loss. On physical examination, she was afebrile and tachypneic. A hard-fixed swelling of 2 × 2 cm with normal overlying skin was found in right cervical region, which moved with deglutition. On systemic examination, breath sounds were found to be decreased on right side. Skiagram of chest revealed bilateral pleural effusion (right more than left) [Figure 1]. Her hemogram was normal except a slightly raised total leukocyte count (13,000/mm3). Liver and renal functions were normal. Echocardiography was done which revealed mild pericardial effusion. Computed tomography (CT) of the chest showed bilateral moderate pleural effusion with mild pericardial effusion [Figure 2]. Ultrasonography of the neck revealed a hyperechoic, oval nodule in right lobe of thyroid. Thyroid functions were normal. Fine needle aspiration cytology (FNAC) of thyroid nodule revealed large cells with multinucleation and prominent nucleoli with presence of mitotic figures and absent colloid favoring anaplastic carcinoma [Figure 3]. Diagnostic thoracentesis revealed clear, amber-colored pleural fluid which was exudative in nature with low cell count. It was negative for acid-fast bacilli and bacteria on smear examination. Pleural fluid cytology revealed malignant cells arranged in three-dimensional (3D) ball clusters and groups [Figure 4]. Correlation with pleural fluid cytology revealed that the cells in thyroid FNA and pleural fluid were cytologically same. Pleural fluid thyroglobulin levels were not raised. Radioiodine tracer uptake revealed poor uptake of radiocontrast further confirming anaplastic nature. Consequently, she was diagnosed as anaplastic thyroid carcinoma with metastatic bilateral pleural and pericardial effusion. She was referred to the department of oncology for management.

Bottom Line: Anaplastic thyroid cancer presenting as bilateral malignant pleural effusion is rarely reported.We present a case who presented solely with respiratory symptoms and subsequently found to be having bilateral malignant pleural effusion secondary to anaplastic thyroid cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.

ABSTRACT
Anaplastic thyroid cancer presenting as bilateral malignant pleural effusion is rarely reported. We present a case who presented solely with respiratory symptoms and subsequently found to be having bilateral malignant pleural effusion secondary to anaplastic thyroid cancer.

No MeSH data available.


Related in: MedlinePlus