Papillary thyroid carcinoma: with cystic lymphadeopathy

Case contributed by Dr Henry Knipe

Presentation

Neck lump.

Patient Data

Age: 30
Gender: Female

Hypoechoic nodule in the right thyroid gland, which demonstrates ill-defined margins and internal vascularity. Right cervical lymphadenopathy. 

Mass arising from the right thyroid gland, with pathologically enlarged low-density lymph nodes throughout the right neck. 

The patient proceeded to total thyroidectomy and right/central neck dissection. 

Histopathology:

  • Total thyroidectomy: Papillary thyroid carcinoma.
    • 14mm maximum dimension.
    • No extrathyroidal extension.
    • No lymphovascular space invasion.
    • Abuts posterior margin.
    • 2/3 perithyroid lymph nodes contain metastatic carcinoma.
  • Right neck dissection, Levels II-IV: 13/25 lymph nodes contain metastatic carcinoma.
  • Right level VI neck dissection: 6/7 lymph nodes contain metastatic carcinoma.

Case Discussion

Papillary thyroid cancer is one of the known causes of cystic (or necrotic) lymph nodes

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