Intratumoural metastasis of primary lung adenocarcinoma to non-invasive follicular thyroid neoplasm with papillary-like nuclear features.

IF 4.4 Q1 PATHOLOGY PATHOLOGICA Pub Date : 2023-06-01 DOI:10.32074/1591-951X-780
Subhash Yadav, Suman Kumar Ankathi, Asawari Patil, Rajiv Kaushal
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Abstract

Metastasis to the thyroid gland is very uncommon with an incidence of 2-3% of all thyroid malignancies. A higher incidence is noted in autopsy studies indicating incidental detection. However, tumour-to-tumour metastasis is extremely uncommon with a handful of cases published in the literature to date. Also, non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P) is a rare neoplasm; diagnosis requires meticulous sampling of the entire capsule and fulfilment of other diagnostic criteria. We report a case of primary adenocarcinoma of lung in a 57-year-old female who additionally had a left thyroid nodule which appeared suspicious on ultrasonography. Histology of lung tumour was conventional papillary adenocarcinoma while aspiration cytology from the thyroid raised suspicion of metastatic adenocarcinoma. On hemithyroidectomy, the thyroid nodule showed metastatic adenocarcinoma in the centre of the nodule, while the peripheral portion showed non-invasive follicular thyroid neoplasm with papillary-like nuclear features; the diagnosis of which was confirmed with complete sampling of the thyroid capsule. The immunoprofile also supported the above dual histology. This is an extremely uncommon occurrence and metastasis within a NIFT-P has not been reported to the best of our knowledge.

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原发性肺腺癌向具有乳头状核特征的非侵袭性滤泡甲状腺肿瘤的瘤内转移。
甲状腺转移是非常罕见的,发病率为2-3%的所有甲状腺恶性肿瘤。在尸检研究中注意到较高的发病率,表明偶然发现。然而,肿瘤到肿瘤的转移极为罕见,迄今为止文献中仅发表了少数病例。此外,具有乳头状核特征的非侵袭性滤泡性甲状腺肿瘤(NIFT-P)是一种罕见的肿瘤;诊断需要对整个胶囊进行细致的采样,并满足其他诊断标准。我们报告一个57岁女性的原发性肺腺癌病例,她同时有左侧甲状腺结节,超声检查显示可疑。肺肿瘤组织学为常规乳头状腺癌,甲状腺细胞学检查怀疑为转移性腺癌。半甲状腺切除术中,甲状腺结节中心为转移性腺癌,周围部分为无浸润性滤泡性甲状腺肿瘤,核呈乳头状;甲状腺包膜的完整取样证实了其诊断。免疫图谱也支持上述双重组织学。这是一种非常罕见的情况,据我们所知,在NIFT-P内转移尚未报道。
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来源期刊
PATHOLOGICA
PATHOLOGICA PATHOLOGY-
CiteScore
5.90
自引率
5.70%
发文量
108
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