Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis

Defining the histologic variant of thyroid carcinoma is an important clinical implication as their progression, recurrence, aggressiveness, and prognosis differ. Warthin-like variant is one of the rarest histologic variants of papillary thyroid cancer. A 36-year-old female sought consult for assessm...

Full description

Saved in:
Bibliographic Details
Main Authors: Karla Judith González-Colunga, Abelardo Loya-Solis, Luis Ángel Ceceñas-Falcón, Oralia Barboza-Quintana, René Rodríguez-Gutiérrez
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2015/251898
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849694443286822912
author Karla Judith González-Colunga
Abelardo Loya-Solis
Luis Ángel Ceceñas-Falcón
Oralia Barboza-Quintana
René Rodríguez-Gutiérrez
author_facet Karla Judith González-Colunga
Abelardo Loya-Solis
Luis Ángel Ceceñas-Falcón
Oralia Barboza-Quintana
René Rodríguez-Gutiérrez
author_sort Karla Judith González-Colunga
collection DOAJ
description Defining the histologic variant of thyroid carcinoma is an important clinical implication as their progression, recurrence, aggressiveness, and prognosis differ. Warthin-like variant is one of the rarest histologic variants of papillary thyroid cancer. A 36-year-old female sought consult for assessment of a painless right neck tumor. High-resolution neck ultrasound revealed a right hypoechoic, 1.71 × 1.05 cm thyroid nodule. Ultrasound-guided fine-needle aspiration biopsy report was a Bethesda grade III. Thyroid function tests showed Hashimoto’s thyroiditis. The patient underwent right hemithyroidectomy. Microscopically, the tumor was composed of papillae lined by cells with eosinophilic cytoplasm, nuclear chromatin clearing, grooves, and pseudoinclusions and a characteristic lymphoplasmacytic infiltrate of the papillae cores. Extension into the perithyroidal soft tissue and 3 ipsilateral lymph nodes was found to be positive for cancer. Warthin-like variant is an uncommon and relatively unknown variant of papillary thyroid carcinoma that has been usually associated with an excellent prognosis. Interestingly, BRAF mutations have been reported to be present in up to 75% of the patients. It is frequently associated with Hashimoto’s thyroiditis and presents unique morphological features that make it recognizable on histologic examination. The cytological diagnosis is difficult to assess due to the overlap in its findings with the classical variant and Hashimoto’s thyroiditis.
format Article
id doaj-art-fa6cc2e147be4d2e99e3e46f34e843ca
institution DOAJ
issn 2090-6501
2090-651X
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series Case Reports in Endocrinology
spelling doaj-art-fa6cc2e147be4d2e99e3e46f34e843ca2025-08-20T03:20:04ZengWileyCase Reports in Endocrinology2090-65012090-651X2015-01-01201510.1155/2015/251898251898Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s ThyroiditisKarla Judith González-Colunga0Abelardo Loya-Solis1Luis Ángel Ceceñas-Falcón2Oralia Barboza-Quintana3René Rodríguez-Gutiérrez4Pathology Department, University Hospital “Dr. José E. González” and Medical School of the Autonomous University of Nuevo Leon, Madero and Gonzalitos s/n, 64460 Monterrey, Nuevo León, MexicoPathology Department, University Hospital “Dr. José E. González” and Medical School of the Autonomous University of Nuevo Leon, Madero and Gonzalitos s/n, 64460 Monterrey, Nuevo León, MexicoPathology Department, University Hospital “Dr. José E. González” and Medical School of the Autonomous University of Nuevo Leon, Madero and Gonzalitos s/n, 64460 Monterrey, Nuevo León, MexicoPathology Department, University Hospital “Dr. José E. González” and Medical School of the Autonomous University of Nuevo Leon, Madero and Gonzalitos s/n, 64460 Monterrey, Nuevo León, MexicoEndocrinology Division, University Hospital “Dr. José E. González” and Medical School of the Autonomous University of Nuevo Leon, Madero and Gonzalitos s/n, 64460 Monterrey, Nuevo León, MexicoDefining the histologic variant of thyroid carcinoma is an important clinical implication as their progression, recurrence, aggressiveness, and prognosis differ. Warthin-like variant is one of the rarest histologic variants of papillary thyroid cancer. A 36-year-old female sought consult for assessment of a painless right neck tumor. High-resolution neck ultrasound revealed a right hypoechoic, 1.71 × 1.05 cm thyroid nodule. Ultrasound-guided fine-needle aspiration biopsy report was a Bethesda grade III. Thyroid function tests showed Hashimoto’s thyroiditis. The patient underwent right hemithyroidectomy. Microscopically, the tumor was composed of papillae lined by cells with eosinophilic cytoplasm, nuclear chromatin clearing, grooves, and pseudoinclusions and a characteristic lymphoplasmacytic infiltrate of the papillae cores. Extension into the perithyroidal soft tissue and 3 ipsilateral lymph nodes was found to be positive for cancer. Warthin-like variant is an uncommon and relatively unknown variant of papillary thyroid carcinoma that has been usually associated with an excellent prognosis. Interestingly, BRAF mutations have been reported to be present in up to 75% of the patients. It is frequently associated with Hashimoto’s thyroiditis and presents unique morphological features that make it recognizable on histologic examination. The cytological diagnosis is difficult to assess due to the overlap in its findings with the classical variant and Hashimoto’s thyroiditis.http://dx.doi.org/10.1155/2015/251898
spellingShingle Karla Judith González-Colunga
Abelardo Loya-Solis
Luis Ángel Ceceñas-Falcón
Oralia Barboza-Quintana
René Rodríguez-Gutiérrez
Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis
Case Reports in Endocrinology
title Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis
title_full Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis
title_fullStr Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis
title_full_unstemmed Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis
title_short Warthin-Like Papillary Thyroid Carcinoma Associated with Lymphadenopathy and Hashimoto’s Thyroiditis
title_sort warthin like papillary thyroid carcinoma associated with lymphadenopathy and hashimoto s thyroiditis
url http://dx.doi.org/10.1155/2015/251898
work_keys_str_mv AT karlajudithgonzalezcolunga warthinlikepapillarythyroidcarcinomaassociatedwithlymphadenopathyandhashimotosthyroiditis
AT abelardoloyasolis warthinlikepapillarythyroidcarcinomaassociatedwithlymphadenopathyandhashimotosthyroiditis
AT luisangelcecenasfalcon warthinlikepapillarythyroidcarcinomaassociatedwithlymphadenopathyandhashimotosthyroiditis
AT oraliabarbozaquintana warthinlikepapillarythyroidcarcinomaassociatedwithlymphadenopathyandhashimotosthyroiditis
AT renerodriguezgutierrez warthinlikepapillarythyroidcarcinomaassociatedwithlymphadenopathyandhashimotosthyroiditis