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Riedel's thyroiditis containing cytologically atypically appearing B-cells: a case report.

Masaru Kojima1, Shigeo Nakamura, Yuko Yamane

  • 1Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan. mkojima@gunma-cc.jp

Pathology, Research and Practice
|October 3, 2003
PubMed
Summary

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This case study describes Riedel's thyroiditis with atypical B-cells in a Japanese female. Immunohistochemistry confirmed the polyclonal nature of these B-cells in both thyroid and lymph node tissues.

Area of Science:

  • Endocrinology
  • Immunopathology
  • Surgical Pathology

Background:

  • Riedel's thyroiditis is a rare, benign thyroid condition characterized by dense fibrosis.
  • The presence of atypical B-cells within Riedel's thyroiditis is an unusual finding requiring careful distinction from malignant neoplasms.

Observation:

  • A 60-year-old Japanese female presented with a thyroid mass showing extensive local growth.
  • Histological examination revealed a biphasic lesion with spindle cells, collagen, and scattered atypical B-cells in the central area.
  • The periphery showed lymphoplasmacytic infiltration, including B-immunoblasts and plasmablasts, with lymphoepithelial-like lesions.

Findings:

  • A subsequent lymph node biopsy revealed a reactive lymphoplasmacytic proliferation.
  • Immunohistochemistry and PCR demonstrated a polyclonal B-cell population in both the thyroid and lymph node lesions.

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  • These findings indicate a reactive B-cell process associated with Riedel's thyroiditis.

    • Implications:

    • This case highlights the importance of considering reactive B-cell proliferation in the differential diagnosis of thyroid lesions with atypical cytology.
    • Accurate diagnosis is crucial to avoid misclassification as lymphoma and unnecessary aggressive treatment.
    • Further research may elucidate the specific immune mechanisms driving B-cell involvement in Riedel's thyroiditis.