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Eur Arch Otorhinolaryngol. 2016 Oct;273(10):2867-75. doi: 10.1007/s00405-015-3786-3. Epub 2015 Oct 12.

Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved?

Author information

1
Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK.
2
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
3
Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA.
4
Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
5
Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
6
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
7
Department of Pathology, Allegiance Health, Jackson, MI, USA.
8
University of Udine School of Medicine, Udine, Italy.
9
Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
10
University Pathologists, Providence, RI and Fall River, MA, USA.
11
Departments of Surgery and Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
12
Coordinator of the International Head and Neck Scientific Group, Padua, Italy. a.ferlito@uniud.it.

Abstract

The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over normal-looking, nodal, thyroid follicles. Arguments for and against the benign nature of these follicles are considered together with processes that could be involved in their formation. The admittedly limited evidence suggests that benign, thyroid follicular inclusions rarely occur in cervical lymph nodes. Histological criteria that could be helpful in recognizing the inclusions, which include assessing their extent in conjunction with the size of the node, are discussed. Finally, an algorithm based on collaboration between specialists, correlating histological findings with imaging and loco-regional control of the upper aero-digestive tract cancer, is suggested for the management of patients with incidentally discovered, nodal thyroid tissue.

KEYWORDS:

Heterotopia; Lymph nodes; Metastasis; Neck dissection; Pathology; Thyroid

PMID:
26459007
PMCID:
PMC5525538
DOI:
10.1007/s00405-015-3786-3
[Indexed for MEDLINE]
Free PMC Article

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