Metastatic Tumors and Lymphomas

  • Lester J. Layfield
  • Jerry Waisman
  • Kristen A. Atkins


Metastases from distant organs and direct extension of tumors from adjacent structures are uncommon but important to recognize in fine needle aspiration (FNA) samples of thyroid nodules. In rare cases, a metastasis to the thyroid can even be the initial presentation of a distant malignancy. Tumors of nearby structures that can involve the thyroid include those of the pharynx, larynx, esophagus, mediastinum, and nearby lymph nodes. The most common origins of metastases to the thyroid are cancers of the lung, breast, skin (especially melanoma), colon, and kidney. The incidence varies in surgical vs. autopsy series (2.7–4.0%). Metastases, including micrometastases, are found in up to 10% of cancer necropsies. Metastatic carcinomas characteristically present in one of three patterns; (1) multiple small discrete nodules (less than 2 mm); (2) solitary large nodules; and (3) diffuse involvement. When small nodules are present, neoplastic cells are admixed with indigenous follicular epithelial cells. With large nodules, the malignant cells are not mixed with follicular epithelial cells. With routine and special stains, distinction of metastatic carcinoma from a primary neoplasm of the thyroid is achievable, but, to assist with this, clinicians are expected to supply the history of malignancy on the requisition form.


Thyroid Gland Malt Lymphoma Renal Cell Carcinoma Hashimoto Thyroiditis Thyroid Lymphoma 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Lester J. Layfield
    • 1
  • Jerry Waisman
    • 2
  • Kristen A. Atkins
    • 3
  1. 1.Department of PathologyUniversity of Utah Hospital and ClinicsSalt Lake CityUSA
  2. 2.Department of PathologyNew York University of MedicineNew YorkUSA
  3. 3.Department of PathologyUniversity of Virginia Health SystemCharlottesvilleUSA

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