Sporadic medullary microcarcinoma in a male patient with concurrent Hashimoto’s hypothyroidism and Kikuchi disease

Choi, Mi-Rim; Yoo, Seol-Bong; Kim, Ji Hye

doi:10.3904/kjim.2014.395

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…Hence, the presence of amyloid material and calcitonin in the surgical specimen, although suggestive, are not decisive to specify the source of elevated peripheral calcitonin levels [15]. The association of Hashimoto's thyroiditis with follicular and papillary cancer and thyroid lymphoma has been previously described [16]. Its presentation along with MTC is rare, making our case even more unique.…”

Section: Discussionmentioning

confidence: 73%

Mediastinal Mass as First Clinical Manifestation of Medullary Thyroid Microcarcinoma in a Patient With Hashimoto’s Thyroiditis

et al. 2022

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Medullary thyroid cancer is a rare neuroendocrine tumor with aggressive behavior and an uncertain prognosis. Calcitonin is the associated tumor marker; however, neuroendocrine tumors of the lung or intestine can also present high values. We report the case of a 53-year-old patient presenting with dry cough for 3 years. Computed tomography (CT) showed a 58-mm expansive lesion in the right anterior mediastinum and cervical ultrasound informed a 9-mm hypoechoic nodule with a lobulated edge and thick calcifications. Cytology reported Hashimoto's thyroiditis. He underwent emergent surgery for respiratory failure. The pathological study informed G2 neuroendocrine carcinoma, immunohistochemistry showed: cytokeratin (+), vimentin (+), alpha-actin (-), synaptophysin (+), chromogranin (+), Ki-67: 10%. He progressed with bone metastasis visualized in scintigraphy and mediastinal tumor remnants, adenopathy, and pulmonary nodules on CT scan, prompting chemotherapy. Due to elevated and increasing calcitonin, an ultrasound study with needle washout for calcitonin resulted in 1,724 pg/mL, and cytology of the nodule reported medullary carcinoma. He was finally diagnosed with medullary thyroid microcarcinoma with metastasis to the mediastinum. Coexistence with Hashimoto's thyroiditis could alter the initial fine-needle aspiration results. We conclude that in the case of calcitonin-secreting neuroendocrine tumors or medullary thyroid cancer, calcitonin fine needle aspirate washout may be helpful in elucidating a diagnosis. Due to its severity, medullary thyroid cancer should always be approached and managed aggressively, even microcarcinomas.

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Section: Discussionmentioning

confidence: 73%

Mediastinal Mass as First Clinical Manifestation of Medullary Thyroid Microcarcinoma in a Patient With Hashimoto’s Thyroiditis

et al. 2022

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“…Although Kikuchi disease is considered a rare condition, there have been numerous case reports of its occurrence in conjunction with other diseases. [23][24][25][26][27][28][29] We believe that many case reports could be merely coincidental. However, in our study we conducted a comprehensive review within a large Kikuchi disease cohort, focusing upon various haematological malignancies, and identified Kikuchi disease occurring in patients with acute leukaemia as a distinct clinical syndrome.…”

Section: Discussionmentioning

confidence: 99%

Kikuchi disease in acute leukaemia: a distinct clinical syndrome with HLA association

Yu,

Lin

2024

Histopathology

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AimsTo report the clinicopathological features of Kikuchi disease in patients with acute leukaemia, emphasising similarities among cases.Methods and resultsIn a cohort of 454 Kikuchi disease patients, we identified three cases of concurrent acute leukaemia. These patients shared similar clinical traits, with Kikuchi disease emerging approximately a month after induction chemotherapy onset, featuring neck‐region lymphadenopathy. Notably, two patients were middle‐aged, deviating from the typical age distribution of Kikuchi disease. Histologically, these cases aligned with typical Kikuchi disease. Negative immunohistochemical stains (CD34, CD117, ERG, TdT) indicated the absence of extramedullary leukaemic infiltration. Herpes simplex virus immunohistochemical staining was also negative. Significantly, a human leucocyte antigen (HLA) association was observed in these three cases. HLA‐B*15:01, C*04:01, and DRB1*04:06 were more prevalent in these patients compared to the general population (compared with three independent control cohorts: Taiwanese Han Chinese (n = 504), Tzu Chi Taiwanese bone marrow donors (n = 364) and Hong Kong Chinese (n = 5266)).ConclusionsOur study underscores the unique link between Kikuchi disease and acute leukaemia, characterised by specific features and HLA associations. This underlines Kikuchi disease as a possible differential diagnosis in pertinent clinical scenarios. Furthermore, this syndrome offers insights into postchemotherapy immunology in acute leukaemia, enhancing comprehension.

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“…Heterogeneously decreased parenchymal echogenicity and increased vascularity in US findings of HT may mask the malignant nodules of primary thyroid lymphoma, which could lead to a challenging diagnosis ( 7 ). There are few case reports on the synchronous occurrence of HT and MTC ( 8 9 10 ). To the best of our knowledge, there have been no reports focusing on the ultrasonographic findings of concurrent HT with MTC.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, there have been no reports focusing on the ultrasonographic findings of concurrent HT with MTC. Several studies of concurrent HT and MTC have reported various ultrasonographic findings ( 8 9 10 ). Mousa et al ( 8 ) reported a well-defined hypoechoic nodule in a confirmed case of MTC with concurrent HT.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Medullary Carcinoma and Hashimoto’s Thyroiditis: A Case Report with an Emphasis on US Features

Kim

Park

2023

J Korean Soc Radiol

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Medullary thyroid carcinoma (MTC) is a rare malignancy that originates from the parafollicular cells of the thyroid gland. Hashimoto’s thyroiditis (HT) is an autoimmune thyroid disease and is the most common cause of hypothyroidism. Previous studies have frequently discussed the association among HT, papillary thyroid carcinoma, and thyroid lymphoma. However, there have been few reports on the ultrasonographic findings of concomitant HT and MTC. In the present case, a heterogeneous hypoechoic background parenchymal echogenicity, with intraglandular echogenic strands, and increased vascularity were observed. A concurrent, ill-defined, parallel-oriented, heterogeneous hypoechoic mass with central microcalcifications was located at the left thyroid gland, consistent with reported US findings of medullary thyroid carcinoma except for an ill-defined margin in our case.

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Sporadic medullary microcarcinoma in a male patient with concurrent Hashimoto’s hypothyroidism and Kikuchi disease

Cited by 6 publications

References 5 publications

Mediastinal Mass as First Clinical Manifestation of Medullary Thyroid Microcarcinoma in a Patient With Hashimoto’s Thyroiditis

Mediastinal Mass as First Clinical Manifestation of Medullary Thyroid Microcarcinoma in a Patient With Hashimoto’s Thyroiditis

Kikuchi disease in acute leukaemia: a distinct clinical syndrome with HLA association

Concurrent Medullary Carcinoma and Hashimoto’s Thyroiditis: A Case Report with an Emphasis on US Features

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