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Advanced Ultrasound in Diagnosis and Therapy ›› 2023, Vol. 7 ›› Issue (1): 32-37.doi: 10.37015/AUDT.2023.210038

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  • 收稿日期:2021-11-21 接受日期:2021-12-24 出版日期:2023-03-30 发布日期:2023-03-30

Ultrasound of Thyroid Langerhans Cell Histiocytosis with Papillary Thyroid Carcinoma: A Report of Two Cases and Literature Review

Wanqing Tang, MDa, Xiaojuan Zhang, MDa, Xiuyun Tang, MDb, Xinya Wang, MDa, Mingzhu Zhang, MDa, Cheng Zhao, MDa,*()   

  1. a Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
    b Department of Ultrasound, Zibo Central Hospital, Zibo, China
  • Received:2021-11-21 Accepted:2021-12-24 Online:2023-03-30 Published:2023-03-30
  • Contact: Cheng Zhao, MD E-mail:zhaochengdr@163.com

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Abstract:

Langerhans cell histiocytosis (LCH) is an uncommon disease of unknown etiology, which involves mainly in the bone and skin and rarely the thyroid. Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. However, thyroid LCH complicated with PTC is rarer. Awareness of sonographic feature is helpful for clinical managment, especially prior to the surgery. Here, we report two patients who have histologically confirmed thyroid LCH complicated with PTC and summarize these cases with sonographic features including enlargement of the thyroid, multiple hypoechoic nodules with microcalcifications as well as enlarged cervical lymph nodes. The relvent literatures will be reviewed and discussed.

Key words: Fine-needle aspiration, Langerhans cell histiocytosis, Thyroid, Papillary thyroid carcinoma

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Author Gender/Age Initial symptom Organ involvement Thyroid Treatment Outcome
T3 T4 TSH Clinical features
Rajab AlZahrani et al. F/27 Polyuria and polydipsia Multiple organs ↓ NL ↓ A neck swelling Total thyroidectomy, radioiodine adjuvant therapy, prednisone Alive
Xin Wu et al. M/20 Polyuria and polydipsia Multiple organs NL NL NL An extensively enlarged, painless, and diffusely firm thyroid gland Right thyroid lobectomy, Methotrexate, cytosine arabinoside Alive
Yu Zhao et al. M/38 Polyuria and polydipsia Multiple organs NL NL NL Diffuse goiter Total thyroidectomy, chemotherapy Alive
Case 1 M/30 Neck mass Thyroid ↓ ↓ ↑ A neck mass Total thyroidectomy Alive
Case 2 F/54 Neck mass Thyroid NL NL NL A neck mass Total thyroidectomy Alive

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Author Size and location Echogenicity Internal acoustic features Calcification Enlarged lymph nodes Vascularity FNA BRAF gene mutation
Rajab AlZahrani et al. Diffuse thyroid enlargement Hypo Heterogeneity N Y NR PTC with lymphocytic thyroiditis NR
Xin Wu et al. 2.9 × 3.6 × 1.8 cm on the right lobe NR NR Y Y NR PTC NR
Yu Zhao et al. Multiple in both lobes Hypo Heterogeneity Y Y NR PTC with LCH Negative
Case 1 4.0 × 2.6 × 2.3 cm on the left lobe Hypo Heterogeneity Y Y abundant PTC NR
Case 2 Multiple in both lobes Hypo Heterogeneity Y Y Abundant NR NR
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