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Metastatic Tumors and Lymphomas

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

Abstract

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.

Keywords

Thyroid Gland Malt Lymphoma Renal Cell Carcinoma Hashimoto Thyroiditis Thyroid Lymphoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Willis RA. The spread of tumors in the human body. London: Butterworth; 1952:271-275.Google Scholar
  2. 2.
    Disibio G, French SW. Metastatic patterns of cancers: results from a large autopsy study. Arch Pathol Lab Med. 2008;132(6):931-939.PubMedGoogle Scholar
  3. 3.
    Czech JM, Lichtor TR, Carney JA, van Heerden JA. Neoplasms metastatic to the thyroid gland. Surg Gynecol Obstet. 1982;155(4):503-505.PubMedGoogle Scholar
  4. 4.
    Ivy HK. Cancer metastatic to the thyroid: a diagnostic problem. Mayo Clin Proc. 1984;59(12):856-859.PubMedGoogle Scholar
  5. 5.
    Shimaoka K, Sokal JE, Pickren JW. Metastatic neoplasms in the thyroid gland. Pathological and clinical findings. Cancer. 1962;15:557-565.CrossRefPubMedGoogle Scholar
  6. 6.
    Schroder S, Burk CG, de Heer K. Metastases of the thyroid gland–morphology and clinical aspects of 25 secondary thyroid neoplasms. Langenbecks Arch Chir. 1987;370(1):25-35.CrossRefPubMedGoogle Scholar
  7. 7.
    Cibas ES, Alexander EK, Benson CB, et al. Indications for thyroid FNA and pre-FNA requirements: a synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36(6):390-399.CrossRefPubMedGoogle Scholar
  8. 8.
    Derringer GA, Thompson LDR, Frommelt RA, Bijwaard KE, Heffess CS, Abbondanzo SL. Malignant lymphoma of the thyroid gland: a clinicopathologic study of 108 cases. Am J Surg Pathol. 2000;24:623-639.CrossRefPubMedGoogle Scholar
  9. 9.
    Lehur PA, Cote RA, Poisson J, Boctor M, Elhilali M, Kandalaft N. Thyroid metastasis of clear-cell renal carcinoma. Can Med Assoc J. 1983;128(2):154-156.PubMedGoogle Scholar
  10. 10.
    Shima H, Mori H, Takahashi M, Nakamura S, Miura K, Tarao M. A case of renal cell carcinoma solitarily metastasized to thyroid 20 years after the resection of primary tumor. Pathol Res Pract. 1985;179(6):666-672.PubMedGoogle Scholar
  11. 11.
    Lasser A, Rothman JG, Calamia VJ. Renal-cell carcinoma metastatic to the thyroid. Aspiration cytology and histologic findings. Acta Cytol. 1985;29(5):856-858.PubMedGoogle Scholar
  12. 12.
    Variakojis D, Getz ML, Paloyan E, Straus FH. Papillary clear cell carcinoma of the thyroid gland. Hum Pathol. 1975;6(3):384-390.CrossRefPubMedGoogle Scholar
  13. 13.
    Layfield LJ, Ostrzega N. Fine needle aspirate smear morphology in metastatic melanoma. Acta Cytol. 1989;33(5):606-612.PubMedGoogle Scholar
  14. 14.
    Smith SA, Gharib H, Goellner JR. Fine-needle aspiration: usefulness for diagnosis and management of metastatic carcinoma to the thyroid. Arch Intern Med. 1987;147:311-312.CrossRefPubMedGoogle Scholar
  15. 15.
    Pedersen RK, Pedersen NT. Primary non-Hodgkin’s lymphoma of the thyroid gland: a population based study. Histopathology. 1996;28(1):25-32.CrossRefPubMedGoogle Scholar
  16. 16.
    Lerma E, Arguelles R, Rigla M, et al. Comparative findings of lymphocytic thyroiditis and thyroid lymphoma. Acta Cytol. 2003;47(4):575-580.PubMedGoogle Scholar
  17. 17.
    Kossev P, Livolsi V. Lymphoid lesions of the thyroid: review in light of the revised European-American lymphoma classification and upcoming World Health Organization classification. Thyroid. 1999;9(12):1273-1280.CrossRefPubMedGoogle Scholar
  18. 18.
    Moshynska OV, Saxena A. Clonal relationship between Hashimoto thyroiditis and thyroid lymphoma. J Clin Pathol. 2008;61(4):438-444.CrossRefPubMedGoogle Scholar
  19. 19.
    Saxena A, Alport EC, Moshynska O, Kanthan R, Boctor MA. Clonal B cell populations in a minority of patients with Hashimoto’s thyroiditis. J Clin Pathol. 2004;57(12):1258-1263.CrossRefPubMedGoogle Scholar
  20. 20.
    Chen HI, Akpolat I, Mody DR, et al. Restricted kappa/lambda light chain ratio by flow cytometry in germinal center B cells in Hashimoto thyroiditis. Am J Clin Pathol. 2006;125(1):42-48.PubMedGoogle Scholar
  21. 21.
    Sangalli G, Serio G, Zampatti C, Lomuscio G, Colombo L. Fine needle aspiration cytology of primary lymphoma of the thyroid: a report of 17 cases. Cytopathology. 2001;12(4):257-263.CrossRefPubMedGoogle Scholar
  22. 22.
    Murphy BA, Meda BA, Buss DH, Geisinger KR. Marginal zone and mantle cell lymphomas: assessment of cytomorphology in subtyping small B-cell lymphomas. Diagn Cytopathol. 2003;28(3):126-130.CrossRefPubMedGoogle Scholar
  23. 23.
    Al-Marzooq YM, Chopra R, Younis M, Al-Mulhim AS, Al-Mommatten MI, Al-Omran SH. Thyroid low-grade B-cell lymphoma (MALT type) with extreme plasmacytic differentiation: report of a case diagnosed by fine-needle aspiration and flow cytometric study. Diagn Cytopathol. 2004;31(1):52-56.CrossRefPubMedGoogle Scholar
  24. 24.
    Tani E, Skoog L. Fine needle aspiration cytology and immunocytochemistry in the diagnosis of lymphoid lesions of the thyroid gland. Acta Cytol. 1989;33(1):48-52.PubMedGoogle Scholar

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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