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Langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying metastatic thyroid papillary carcinoma.

Ceyran AB, Senol S, Bayraktar B, Ozkanlı S, Cinel ZL, Aydın A - Case Rep Pathol (2014)

Bottom Line: The pathological diagnosis was reported as papillary thyroid carcinoma.It is also associated with a family history of thyroid disease.The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Göztepe Research and Training Hospital, Istanbul Medeniyet University, Turkey.

ABSTRACT
A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma.

No MeSH data available.


Related in: MedlinePlus

High power view of LCH foci in the thyroid tissues. Langerhans cells in granuloma-like groups and a number of eosinophil leukocytes (H.E. ×400).
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fig3: High power view of LCH foci in the thyroid tissues. Langerhans cells in granuloma-like groups and a number of eosinophil leukocytes (H.E. ×400).

Mentions: Microscopic examination of LCH foci of both thyroid lobes showed papillary carcinoma foci presenting with diffuse chronic lymphocytic thyroiditis and granuloma-like groups. Granuloma-like groups consist of an abundant number of eosinophil leukocytes and Langerhans cells. Langerhans cells have abundant pale eosinophilic cytoplasm and vesicular nuclei with an indented “coffee bean” appearance (Figure 3). The lymph nodes demonstrated diffuse LCH foci adjacent to the metastatic sites in metastatic papillary carcinoma lymph nodes and sinusoidal invasion of LCH in nonmetastatic papillary carcinoma lymph nodes (Figures 4 and 5). The immunohistochemical analysis showed a positive staining with S-100 and CD 1a in the Langerhans cells in all involved sites (Figures 6 and 7). There was no intrathyroidal lymphatic invasion of PTC with D2-40 stain.


Langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying metastatic thyroid papillary carcinoma.

Ceyran AB, Senol S, Bayraktar B, Ozkanlı S, Cinel ZL, Aydın A - Case Rep Pathol (2014)

High power view of LCH foci in the thyroid tissues. Langerhans cells in granuloma-like groups and a number of eosinophil leukocytes (H.E. ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4202248&req=5

fig3: High power view of LCH foci in the thyroid tissues. Langerhans cells in granuloma-like groups and a number of eosinophil leukocytes (H.E. ×400).
Mentions: Microscopic examination of LCH foci of both thyroid lobes showed papillary carcinoma foci presenting with diffuse chronic lymphocytic thyroiditis and granuloma-like groups. Granuloma-like groups consist of an abundant number of eosinophil leukocytes and Langerhans cells. Langerhans cells have abundant pale eosinophilic cytoplasm and vesicular nuclei with an indented “coffee bean” appearance (Figure 3). The lymph nodes demonstrated diffuse LCH foci adjacent to the metastatic sites in metastatic papillary carcinoma lymph nodes and sinusoidal invasion of LCH in nonmetastatic papillary carcinoma lymph nodes (Figures 4 and 5). The immunohistochemical analysis showed a positive staining with S-100 and CD 1a in the Langerhans cells in all involved sites (Figures 6 and 7). There was no intrathyroidal lymphatic invasion of PTC with D2-40 stain.

Bottom Line: The pathological diagnosis was reported as papillary thyroid carcinoma.It is also associated with a family history of thyroid disease.The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Göztepe Research and Training Hospital, Istanbul Medeniyet University, Turkey.

ABSTRACT
A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma.

No MeSH data available.


Related in: MedlinePlus