A Case of Papillary Carcinoma of the Thyroid Gland with Concurrent Tuberculous Lymphadenitis

Abstract

We report a case of papillary carcinoma of the thyroid gland and cervical lymph node metastases with concurrent tuberculous lymphadenitis that was diagnosed preoperatively. A 35-year-old woman presented with multiple lymph node swellings and an anterior neck mass. No findings suggesting the coexistence of pulmonary tuberculosis were present. The patient underwent a total thyroidectomy with bilateral neck dissection together with medication. Measures to prevent tuberculosis were undertaken during the perioperative period. The histopathological diagnosis was papillary carcinoma with both metastatic and tuberculous lymphadenitis of the lymph nodes in the neck. The possible coexistence of tuberculous lymphadenitis must be ruled out when lymph node swellings are observed in patients with head and neck cancer, including thyroid carcinoma.

Preoperatively diagnosed case with co-existence of papillary thyroid carcinoma and cervical tuberculous lymphadenitis

“…We preoperatively diagnoses and treated a rare case with coexistence of thyroid cancer and cervical tuberculous lymphadenitis by FNAB and QFT-2G testing. Some similar cases have been reported to date [6,7,17,18] , but preoperative diagnosis was impossible for most cases. In only one case [18] , cervical tuberculous lymphadenitis was incidentally suspected after FNAC, although the author described that it seemed clinically indistinguishable from a metastatic lymph node even if retrospectively evaluated.…”

“…Some similar cases have been reported to date [6,7,17,18] , but preoperative diagnosis was impossible for most cases. In only one case [18] , cervical tuberculous lymphadenitis was incidentally suspected after FNAC, although the author described that it seemed clinically indistinguishable from a metastatic lymph node even if retrospectively evaluated. We could not distinguish whether cervical lymph nodes enlargement was due to PTC metastasis or tuberculosis infection by clinical findings or imaging studies, either.…”

Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma

“…The coexistence of PTC and TB lymphadenitis has been described in several case reports from India, Korea, Japan, and the US [ 3 , 6 – 8 ]. In a case series of PTC patients with lymphadenopathy, 72% (18/25) were eventually diagnosed with TB lymphadenitis after an initial consideration of metastasis from PTC [ 9 ].…”