Co-existence of Papillary Thyroid Cancer with Tuberculosis Involving the Thyroid and Ipsilateral Paratracheal Lymph Node: A Case Report

Jin Sah Dae; Ha Choi Jeon; Jung Kim Yoon; Woo Kim Seung

doi:10.11106/jkta.2013.6.2.131

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Dae, Jeon, Yoon, and Seung: Co-existence of Papillary Thyroid Cancer with Tuberculosis Involving the Thyroid and Ipsilateral Paratracheal Lymph Node: A Case Report

Original Article

J Korean Thyroid Assoc 2013;6(2):131-134.

Published online: 3 May 2013

DOI: https://doi.org/10.11106/jkta.2013.6.2.131

Co-existence of Papillary Thyroid Cancer with Tuberculosis Involving the Thyroid and Ipsilateral Paratracheal Lymph Node: A Case Report

Jin Sah Dae, Ha Choi Jeon, Jung Kim Yoon, Woo Kim Seung

¹Departments of Otolaryngology-Head and Neck Surgery, VHS Medical Center, Seoul, Korea

²Departments of Pathology, VHS Medical Center, Seoul, Korea

Address reprint requests to Seung Woo Kim, MD, Department of Otolaryngology-Head and Neck Surgery, VHS Medical Center, 6-2 Dunchon-dong, Gangdong-gu, Seoul 134-791, Korea Tel: 82-2-2225-1384, Fax: 82-2-2225-1385, E-mail: entzzang1020@daum.net

Received 23 July 2013 Accepted 21 October 2013

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There are relatively rare cases concerning about concurrent papillary thyroid cancer and thyroid tuberculosis with cervical tuberculous lymphadenitis in English literature so far. Cervical lymphadenitis (scrofula) is a common manifestation of extra-pulmonary invasion of the tuberculosis. A cervical tuberculous lymphadenitis could be confused with metastatic lymph node from the thyroid cancer. A 49-year-old woman with multiple right thyroid nodules of Bethesda category VI referred our department for surgery. We performed the right thyroid lobectomy with anterior compartment neck dissection. The histopathology revealed concurrent papillary thyroid carcinoma and thyroid tuberculosis with cervical tuberculous lymphadenitis. We report a unique case of concurrent papillary thyroid cancer and tuberculosis involving the thyroid gland and ipsilateral paratracheal lymph node with literature review. To our best knowledge, such case has not been reported earlier.

Keywords: Papillary carcinoma, Thyroid, Tuberculosis, Lymph node

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Fig. 1.

Neck sonography shows round shape hypoechoic thyroid nodule which is probable PTC lesion.

Fig. 2.

Contrast-enhanced neck CT scan shows irregularly-margined and heterogeneously enhanced nodule on right thyroid gland (A), and several enlarged central lymph nodes (B, white arrows).

Fig. 3.

The cut surface of the right thyroid gland. Black arrow shows suspicious tuberculous lesion and white arrow shows suspicious PTC lesion (A). Enlarged paratracheal lymph node (B). Photomicrograph showing caseating necrosis of right thyroid (C) and lymph node (D) which are compatible with PTC (H & E stain, original magnification: C, X200; D, X100).

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