Corrado Stefania, Morgante Cesare, Tassi Sauro, Maccarrone Francesco, Di Massa Gianluca, Pontecorvi Alfredo, Papi Giampaolo
Department of Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy.
Division of Endocrinology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, 00168 Rome, Italy.
Int J Endocrinol Metab. 2023 Apr 1;21(2):e126486. doi: 10.5812/ijem-126486. eCollection 2023 Apr.
Ganglioneuromas are tumors of neurogenic origin usually located in the abdomen, the adrenal glands, and the mediastinum but infrequently found in the neck region.
We describe the case of a four-year-old Albanian girl presenting with an anterior neck mass initially suspected to be a thyroid nodule. From a clinical point of view, there was no evidence of compression on vital cervical structures. Lab tests detected normal serum thyrotropin, calcitonin, and parathormone concentrations. A neck ultrasound showed a huge mass apparently originating from the left thyroid lobe. Cytological examination of fine needle biopsy demonstrated a population of large cells with eosinophilic cytoplasm, regular nuclei, and prominent nucleoli and spindle cells without significant atypia, consistent with a benign lesion of neurogenic origin. Also, the neck MRI displayed a mass with well-defined margins, likely arising from the peripheral nervous system. The patient underwent surgical excision of the mass without complications. The histological exam was diagnostic for ganglioneuroma.
We discuss the cytological and histological features peculiar to such a rare neck lesion and review the differential diagnosis.
神经节神经瘤是神经源性肿瘤,通常位于腹部、肾上腺和纵隔,但在颈部区域很少见。
我们描述了一名4岁阿尔巴尼亚女孩的病例,该女孩颈部前方有肿块,最初怀疑是甲状腺结节。从临床角度来看,没有证据表明重要的颈部结构受到压迫。实验室检查检测到血清促甲状腺激素、降钙素和甲状旁激素浓度正常。颈部超声显示一个巨大肿块,显然起源于左甲状腺叶。细针穿刺活检的细胞学检查显示一群大细胞,胞质嗜酸性,核规则,核仁突出,还有梭形细胞,无明显异型性,符合神经源性良性病变。此外,颈部磁共振成像显示一个边界清晰的肿块,可能起源于周围神经系统。患者接受了肿块的手术切除,无并发症。组织学检查诊断为神经节神经瘤。
我们讨论了这种罕见颈部病变特有的细胞学和组织学特征,并回顾了鉴别诊断。