Synchronous Thyroid Involvement in Plasma Cell Leukemia Masquerading as Hashimoto's Thyroiditis: Role of Ancillary Cytology Techniques in Diagnostic Workup

Tandon, Ashwani; Paul, Tanusree; Singh, Rekha; Narendra, A

doi:10.1007/s12022-015-9392-5

Cited by 3 publications

(5 citation statements)

References 18 publications

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“…Intranuclear inclusions may also be found. The plasmacytoid appearance is also seen in marginal zone lymphoma, extramedullary plasmacytoma of thyroid, and plasma cell granuloma of the thyroid and remain a close differential diagnosis to this entity . In our case, the detection of amyloid helped us in reaching the diagnosis.…”

Section: Discussionsupporting

confidence: 53%

“…The plasmacytoid appearance is also seen in marginal zone lymphoma, extramedullary plasmacytoma of thyroid, and plasma cell granuloma of the thyroid and remain a close differential diagnosis to this entity. 9,10 In our case, the detection of amyloid helped us in reaching the diagnosis. Amyloid is usually seen as acellular material either surrounded by tumor cells or separately.…”

Section: Discussionmentioning

confidence: 59%

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Medullary thyroid carcinoma co‐existent with Hashimoto's thyroiditis diagnosed by a comprehensive cytological approach

Malpani

Tandon

Panwar

et al. 2019

Diagnostic Cytopathology

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Fine‐needle aspiration cytology (FNAC) is a preliminary test for the diagnosis of thyroid lesions. We hereby report a rare case of medullary thyroid carcinoma (MTC) co‐existing with Hashimoto's thyroiditis (HT). This case was substantiated with ancillary tests on cytology material to give a novel insight. A 60‐year‐old female presented clinically with diffuse enlargement of the thyroid, and right‐side nodule on ultrasonography. FNAC of the isthmic area showed features of HT, while cytology of right‐side nodule displayed sheets of plasmacytoid cells and frequent scattered large bizarre and pleomorphic cells, lymphoglandular bodies and pale eosinophilic material. The differential diagnosis of MTC with co‐existent HT or high‐grade lymphoma was considered. To establish the diagnosis, serum calcitonin and ancillary studies on aspirated material were carried out. High serum calcitonin (7251 pg/mL), Congophilia on smears, and CD 45−ve; CD56+ve expression of tumor cells on flowcytometric analysis established the diagnosis of MTC over lymphoma. This diagnosis was further confirmed upon histopathology. Ancillary studies on aspirated material established the diagnosis of MTC and excluded the diagnosis of lymphoma. Establishing the correct diagnosis was cardinal in such a scenario as these diseases have extremely diverse management.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 59%

Medullary thyroid carcinoma co‐existent with Hashimoto's thyroiditis diagnosed by a comprehensive cytological approach

Malpani

Tandon

Panwar

et al. 2019

Diagnostic Cytopathology

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“…Of the various ancillary techniques which can be utilized in cytology as diagnostic aid, cell block, immunocytochemistry (ICC) and flow cytometry are probably the most commonly used. Ancillary studies in thyroid cytology are more useful in rare borderline cases of medullary carcinoma [ 71 ], anaplastic carcinoma [ 72 ], metastases and lymphomas [ 73 ], than in the more common papillary thyroid carcinoma. ICC could be used for diagnosing tuberculous thyroiditis, in which Ziehl-Neelsen staining had failed to reveal acid-fast bacilli [ 74 ].…”

Section: Ancillary Techniquesmentioning

confidence: 99%

“…The mutation was detected in 12% of papillary thyroid carcinomas, which was significantly lower than the expected rate [ 83 , 84 ]. Rare reports of fluorescence in-situ hybridization on cytology smears of thyroid are also available [ 73 ].…”

Section: Ancillary Techniquesmentioning

confidence: 99%

Thyroid Cytology in India: Contemporary Review and Meta-analysis

Agarwal

Jain²

2017

J Pathol Transl Med

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Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

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“…reported a case of plasma cell leukemia in which thyroid involvement was initially masked by Hashimoto's thyroiditis. [8]…”

mentioning

confidence: 99%

Thyroid plasmacytoma: A rare cause of hoarseness of voice

et al. 2019

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Synchronous Thyroid Involvement in Plasma Cell Leukemia Masquerading as Hashimoto's Thyroiditis: Role of Ancillary Cytology Techniques in Diagnostic Workup

Cited by 3 publications

References 18 publications

Medullary thyroid carcinoma co‐existent with Hashimoto's thyroiditis diagnosed by a comprehensive cytological approach

Medullary thyroid carcinoma co‐existent with Hashimoto's thyroiditis diagnosed by a comprehensive cytological approach

Thyroid Cytology in India: Contemporary Review and Meta-analysis

Thyroid plasmacytoma: A rare cause of hoarseness of voice

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