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

doi:10.37015/AUDT.2023.210038

Abstract

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

Wanqing Tang, MD, Xiaojuan Zhang, MD, Xiuyun Tang, MD, Xinya Wang, MD, Mingzhu Zhang, MD, Cheng Zhao, MD. Ultrasound of Thyroid Langerhans Cell Histiocytosis with Papillary Thyroid Carcinoma: A Report of Two Cases and Literature Review. Advanced Ultrasound in Diagnosis and Therapy, 2023, 7(1): 32-37.

Figures/Tables 5

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References 10

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Author	Gender/Age	Initial symptom	Organ involvement	Thyroid				Treatment	Outcome
Author	Gender/Age	Initial symptom	Organ involvement	T3	T4	TSH	Clinical features	Treatment	Outcome
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

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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