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Intrathyroidal branchial cleft-like cyst in chronic thyroiditis
1First Department of Pathology, Kagawa Medical School, Kagawa, Japan. ichibyou@kms.ac.jp
Pathology International
|December 7, 2000
Summary
A rare intrathyroidal branchial cleft-like cyst was found in a 71-year-old man. This unusual neck mass was successfully removed, with no signs of recurrence after 43 months.
Area of Science:
- Endocrinology
- Head and Neck Surgery
- Pathology
Background:
- Branchial cleft cysts are congenital anomalies typically found in the lateral neck.
- Intrathyroidal presentation of these cysts is exceptionally rare, posing diagnostic challenges.
Observation:
- A 71-year-old male presented with a progressively enlarging mass in the right lateral neck.
- Ultrasonography and computed tomography revealed a cystic mass within the upper lobe of the right thyroid gland.
Findings:
- Surgical excision yielded a cystic mass (22 x 20 x 10 mm) with a fibrous capsule.
- Microscopic examination showed squamous epithelium lining the cyst, surrounded by thyroid tissue with significant lymphoid infiltration and lymphoid follicles.
- Immunohistochemistry confirmed squamous epithelium markers (keratin, cytokeratin 19, CEA, EMA) and ruled out neuroendocrine differentiation (calcitonin, chromogranin A negative).
Implications:
- This case highlights the importance of considering rare differential diagnoses for thyroid masses.
- Accurate histopathological and immunohistochemical analysis is crucial for correct diagnosis and management of intrathyroidal cystic lesions.
- Complete surgical resection appears to be an effective treatment for intrathyroidal branchial cleft-like cysts, with favorable long-term outcomes.