Intrathyroidal Thymic Tissue Surrounding an Intrathyroidal Parathyroid Gland, the Cause of a Solitary Thyroid Nodule in a 6-Year-Old Boy

Lignitz, Sarah; Musholt, Thomas J.; Kreft, Andreas; Engel, Roger; Brzezinska, Rita; Pohlenz, Joachim

doi:10.1089/thy.2008.0055

Cited by 26 publications

(30 citation statements)

References 22 publications

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“…He reported a fetus with the thymus buried within thyroid and an instance of thymus in a similar location in an infant [11]. Parathyroid glands also have a similar embriyologic origin, and in fact there have been rare cases of IET accompanying or surrounding intrathyroidal parathyroid gland [12,13]. In 1976, Carpenter et al reported 9 cases with thymus inclusions in thyroid glands of 350 children (2.6%) [14].…”

Section: Discussionmentioning

confidence: 99%

Intrathyroidal ectopic thymus in children: a sonographic survey

et al. 2017

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Aims: Intrathyroidal ectopic thymus (IET) is being increasingly reported in the radiology literature. Most of the reports are of individual cases or small series and prevalence and natural course of the pathology is not well known. The purpose of this study is to establish the prevalence of IET in children and report long term follow-up results.Material and methods: In 180 children who were examined by ultrasound (US) for other reasons, 7 patients were indentified with IET. Together with the other seven children who were already under follow-up for IET (diagnosed using US criteria), these 14 patients were followed up with US for 30 months. Size, shape, location, echotexture and internal echoes of the lesions were evaluated.Results: There were 16 lesions in 14 children. The most common appearance was a fusiform hypoechoic lesion, with punctate and linear internal echoes and well-defined but slightly irregular borders located posteriorly in the lower thirds of the thyroid. In follow-up, there were no changes in echotexture, shape or border. In 3 patients, the lesion became slightly smaller, in a 10-year-old boy slightly larger, and in an 11-year old boy the lesion disappeared. In a patient with bilateral lesions, one lesion slightly decreased in size.Conclusions: IET in children may be more common than thought. Its growth reflects that of a normal thymus. Awareness of this entity is important in order not to misdiagnose them, especially as papillary cancer, and to prevent unnecessary interventions.

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Section: Discussionmentioning

confidence: 99%

Intrathyroidal ectopic thymus in children: a sonographic survey

et al. 2017

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“…The authors also reported an additional patient who underwent thyroid lobectomy because the ectopic thymus was thought to be a tumor [16]. Ectopic intrathyroidal thymus rarely gives rise to symptoms [1,2,3,4,5,6,7]. In the majority of previously reported cases (table 2) the diagnosis of ectopic thymus was made after surgery and/or fine-needle aspiration biopsy because the thymic inclusion was thought to be a thyroid nodule.…”

Section: Discussionmentioning

confidence: 99%

“…In the majority of previously reported cases (table 2) the diagnosis of ectopic thymus was made after surgery and/or fine-needle aspiration biopsy because the thymic inclusion was thought to be a thyroid nodule. The differential diagnoses included medullary thyroid carcinoma [1], T-cell non-Hodgkin’s lymphoma [3], benign nodule [5], thyroid carcinoma [4], thyroiditis, and lymphocytic leukemia [6]. On ultrasonography, thymic tissue has a unique appearance and is characterized by a hypoechoic pattern with multiple regular linear and punctate bright echogenicities (bright internal echoes) that represent connective septa and blood vessels within the septa [8,9].…”

Section: Discussionmentioning

confidence: 99%

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Ectopic Intrathyroidal Thymus in Children: A Long-Term Follow-Up Study

et al. 2010

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Background: Ectopic intrathyroidal thymus has recently been reported in children as a cause of surgery and/or invasive diagnostic procedures when mistaken for a thyroid nodule. Thymus has a unique appearance at ultrasound (US). Methods: We report a follow-up study (mean 34 months, range 6–84) performed by US on 9 children (5 females) with a mean age of 6.3 ± 3.2 years with intrathyroidal thymic inclusions diagnosed by US as ‘incidentalomas’. None has palpable nodules. Results: Intrathyroidal thymic inclusions appeared on US as a hypoechoic area, with regular linear or punctuate internal hyperechoic echoes. The 2 oldest patients (13 and 17 years) showed a regression in both size and hypoechogenicity of thymic inclusions over time – reflecting the normal thymic involution with advancing age. Conclusions: Indeed, the lack of progression seen in our 9 patients over a mean time of 34 months confirmed the substantially benign and self-limited nature of this process. The increasing use of thyroid ultrasonography in children may result in an increased detection of intrathyroidal thymic inclusions – an embryologic anomaly that should be considered in the differential diagnosis of thyroid nodules in children and adolescents.

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“…Previous publications have reported cases of ectopic intrathyroidal thymus that were considered as thyroid nodules, and a fine-needle biopsy or even surgery was performed in order to establish the diagnosis [7,8,14,15]. …”

Section: Discussionmentioning

confidence: 99%

Ectopic Intrathyroidal Thymus in Childhood: A Sonographic Finding Leading to Misdiagnosis

Vlachopapadopoulou¹,

Vakaki

Karachaliou³

et al. 2016

Horm Res Paediatr

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Background: During gestation, the primordial thymus migrates from the pharynx to the anterior mediastinum, thus thymic tissue can remain at any point along this path. Intrathyroidal thymic remnants are rare, and their sonographic patterns have only recently been described. This retrospective study presents the sonographic appearance of ectopic intrathyroidal thymus and emphasizes the role of sonography in order to avoid misdiagnosis. Methods: The population consisted of 42 children, 3.5-14 years old, who had a thyroid sonogram performed due to a positive family history or symptoms indicative of thyroid disease, and ectopic intrathyroidal thymus was recognized. Results: In all patients, the same pattern was revealed: a fusiform intrathyroidal lesion, with no mass effect, homogeneously hypoechoic, with diffuse bright internal echoes. The similarity to the characteristic sonographic pattern of the normal mediastinal thymus was crucial for the diagnosis of ectopic intrathyroidal thymic tissue. In 8 cases, a normal elongated thymus was found connected to the thyroid with an accessory lobe embedded in the lower thyroid pole. The above sonographic appearances mimicked a thyroid nodule. Conclusions: Awareness of the sonographic patterns of the ectopic intrathyroidal thymus is mandatory to avoid misdiagnosis. In most cases, further investigation is unnecessary, but sonographic follow-up should be recommended.

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Intrathyroidal Thymic Tissue Surrounding an Intrathyroidal Parathyroid Gland, the Cause of a Solitary Thyroid Nodule in a 6-Year-Old Boy

Cited by 26 publications

References 22 publications

Intrathyroidal ectopic thymus in children: a sonographic survey

Intrathyroidal ectopic thymus in children: a sonographic survey

Ectopic Intrathyroidal Thymus in Children: A Long-Term Follow-Up Study

Ectopic Intrathyroidal Thymus in Childhood: A Sonographic Finding Leading to Misdiagnosis

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