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Warthin tumor-like papillary thyroid carcinoma – case report

Irena Ranogajec ; Department of Clinical Cytology, Polyclinic Sunce, Zagreb, Croatia
Božena Šarčević ; Department of Pathology, University Hospital for Tumors, University Hospital Center Sestre milosrdnice, Zagreb, Croatia
Renato Janušić ; Janusic Polyclinic, Zagreb, Croatia
Ljiljana Bjelja ; Department of Internal medicine, General Hospital Zabok, Zabok, Croatia

Sažetak

We report a rare case of Warthin tumor-like papillary thyroid carcinoma confi rmed by histology. It is an uncommon variant of papillary thyroid carcinoma with about 80 cases reported in the literature and it is often associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infi ltrating the stalks of the papillae lined with large cells with abundant eosinophilic cytoplasm (oncocytic cells). The epidemiologic features of this variant of papillary thyroid carcinoma are similar to the classic papillary carcinoma. A 58-year-old female patient came to the ultrasound examination of cervical region and the examination detected twonodules; an isoechoic nodule 11 mm in greatest diameter with perilesional vascularisation in the left thyroid lobe and a solid-cystic nodule approximately 15 mm in greatest diameter in the right lobe of the thyroid gland. Ultrasound guided fine needle aspiration (FNA) was performed and cytological analysis indicated papillary carcinoma in the right thyroid lobe.Surgical treatment was performed. Histopathological analysis confi rmed the cytological diagnosis and the final histopathological diagnosis were Warthin tumor-like papillary thyroid carcinoma with lymphocytic thyroiditis and intraglandular tumor spread. Lymph node metastases were excluded as well as vascular invasion and nine months after surgery the patient is fine and disease-free.
This tumor can be easily mistaken for Hurthle cell carcinoma and tall cell variant of papillary carcinoma both by FNA and histology but the lymphocytic infi ltrate within the stalks of the tumor papillae in the histology specimens is a distinctive factor for its diagnosis. The lymphocytic infi ltration in this variant of papillary carcinoma and association with lymphocytic thyroiditis may suggest the role of immunological mechanisms for its pathogenesis and prognosis. In the future, more studies are required for bett er understanding of its biological behaviour.

Ključne riječi

papillary carcinoma; Warthin tumor; FNA cytology; histology; prognosis

Hrčak ID:

190245

URI

https://hrcak.srce.hr/190245

Datum izdavanja:

10.12.2015.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.599 *