Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
JAMA Otolaryngol Head Neck Surg. 2013 Apr;139(4):415-8. doi: 10.1001/jamaoto.2013.227.
There are reports in the literature of anaplastic thyroid carcinoma in cervical lymph nodes with evidence of only papillary carcinoma in the thyroid gland. There have been no cases of this clinical scenario with only papillary microcarcinoma in the thyroid gland.
We describe the case of a 60-year-old man who initially presented with an enlarged right, level 5, supraclavicular lymph node. Initial fine-needle aspiration demonstrated evidence of papillary thyroid carcinoma. The final pathologic finding in the thyroid gland showed only multiple foci of papillary thyroid microcarcinoma. The index neck mass showed evidence of anaplastic thyroid carcinoma.
This is the first instance in the literature in which anaplastic thyroid carcinoma has appeared in metastatic cervical lymph nodes with only a focus of papillary microcarcinoma in the thyroid gland. With this case, we hope to build awareness of this rare finding.
有文献报道称，在甲状腺中仅发现乳头状癌的情况下，颈部淋巴结中存在间变性甲状腺癌。在甲状腺中仅存在乳头状微癌的情况下，尚未出现这种临床情况的病例。
我们描述了一名 60 岁男性的病例，他最初表现为右侧 5 级锁骨上淋巴结肿大。最初的细针穿刺抽吸显示为甲状腺乳头状癌的证据。甲状腺的最终病理结果仅显示多个甲状腺乳头状微癌灶。索引颈部肿块显示出间变性甲状腺癌的证据。
这是文献中首次出现转移性颈淋巴结中仅存在甲状腺内局灶性乳头状微癌的情况下出现间变性甲状腺癌的情况。通过这个病例，我们希望提高对这种罕见发现的认识。
