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Thyroglossal Duct Cyst and Other Ectopic Thyroid Tissues in the Neck

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Thyroid FNA Cytology
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Abstract

A path taken by the developing thyroid during embryogenesis determines a wide area in the anterior neck, which may harbor ectopic thyroid remnants. The most common entity, which requires attention of pathologist, is a thyroglossal duct (TGD) cyst. This midline neck developmental lesion is diagnosed by the presence of epithelial lining and thyroid follicles. Rarely follicular epithelium in the wall of TGD cyst may undergo malignant transformation, giving rise to papillary thyroid carcinoma. Fine-needle aspiration findings in TGD are well described; however utility of cytologic examination is controversial due to low sensitivity. The major indication for fine-needle aspiration is evaluation of suspicious TGD cysts, when cytology may yield atypical cells with characteristic features of papillary carcinoma. Various kinds of microscopic thyroid inclusions accidentally found in the cervical region are important in the context of differential diagnosis with metastatic thyroid cancer. Meticulous search for primary thyroid tumor is a rule of thumb in such a challenging situation.

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References

  1. Allard RH. The thyroglossal cyst. Head Neck Surg. 1982;5:134–46.

    Article  CAS  Google Scholar 

  2. Ellis PD, van Nostrand AW. The applied anatomy of thyroglossal tract remnants. Laryngoscope. 1977;87:765–70.

    Article  CAS  Google Scholar 

  3. Sprinzl GM, Koebke J, Wimmers-Klick J, Eckel HE, Thumfart WF. Morphology of the human thyroglossal tract: a histologic and macroscopic study in infants and children. Ann Otol Rhinol Laryngol. 2000;109:1135–9.

    Article  CAS  Google Scholar 

  4. Lee M, Lee YK, Jeon TJ, Chang HS, Kim BW, Lee YS, et al. Frequent visualization of thyroglossal duct remnant on post-ablation 131I-SPECT/CT and its clinical implications. Clin Radiol. 2015;70:638–43. https://doi.org/10.1016/j.crad.2015.02.018.

    Article  CAS  PubMed  Google Scholar 

  5. Mondin V, Ferlito A, Muzzi E, Silver CE, Fagan JJ, Devaney KO, et al. Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx. 2008;35:11–25. https://doi.org/10.1016/j.anl.2007.06.001.

    Article  PubMed  Google Scholar 

  6. Thompson LD, Herrera HB, Lau SK. A clinicopathologic series of 685 thyroglossal duct remnant cysts. Head Neck Pathol. 2016;10:465–74. https://doi.org/10.1007/s12105-016-0724-7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Foley DS, Fallat ME. Thyroglossal duct and other congenital midline cervical anomalies. Semin Pediatr Surg. 2006;15:70–5. https://doi.org/10.1053/j.sempedsurg.2006.02.003.

    Article  PubMed  Google Scholar 

  8. Zander DA, Smoker WR. Imaging of ectopic thyroid tissue and thyroglossal duct cysts. Radiographics. 2014;34:37–50. https://doi.org/10.1148/rg.341135055.

    Article  PubMed  Google Scholar 

  9. Wagner G, Medina JE. Excision of thyroglossal duct cyst: the Sistrunk procedure. Oper Tech Otolaryngol Head Neck Surg. 2004;15:220–3. https://doi.org/10.1016/j.otot.2004.05.001.

    Article  Google Scholar 

  10. Ali AA, Al-Jandan B, Suresh CS, Subaei A. The relationship between the location of thyroglossal duct cysts and the epithelial lining. Head Neck Pathol. 2013;7:50–3. https://doi.org/10.1007/s12105-012-0396-x.

    Article  PubMed  Google Scholar 

  11. Chandra RK, Maddalozzo J, Kovarik P. Histological characterization of the thyroglossal tract: implications for surgical management. Laryngoscope. 2001;111:1002–5. https://doi.org/10.1097/00005537-200106000-00014.

    Article  CAS  PubMed  Google Scholar 

  12. Assi A, Sironi M, Di Bella C, Declich P, Cozzi L, Pareschi R. Parasitic nodule of the right carotid triangle. Arch Otolaryngol Head Neck Surg. 1996;122:1409–11.

    Article  CAS  Google Scholar 

  13. Shahin A, Burroughs FH, Kirby JP, Ali SZ. Thyroglossal duct cyst: a cytopathologic study of 26 cases. Diagn Cytopathol. 2005;33:365–9. https://doi.org/10.1002/dc.20346.

    Article  PubMed  Google Scholar 

  14. Lee DH, Yoon TM, Lee JK, Lim SC. Is fine needle aspiration cytology appropriate for preoperatively diagnosing thyroglossal duct cysts in children under the age of 10 years? Int J Pediatr Otorhinolaryngol. 2012;76:480–2. https://doi.org/10.1016/j.ijporl.2011.12.029.

    Article  PubMed  Google Scholar 

  15. Wei S, LiVolsi VA, Baloch ZW. Pathology of thyroglossal duct: an institutional experience. Endocr Pathol. 2015;26:75–9. https://doi.org/10.1007/s12022-015-9354-y.

    Article  PubMed  Google Scholar 

  16. Ko AB, Assaad A, Carty SE, Barnes EL, Schaitkin BM. Branchial cleftlike cysts of the thyroid. Am J Otolaryngol. 2006;27:146–8. https://doi.org/10.1016/j.amjoto.2005.07.023.

    Article  PubMed  Google Scholar 

  17. Ryska A, Vokurka J, Michal M, Ludvikova M. Intrathyroidal lymphoepithelial cyst. A report of two cases not associated with Hashimoto’s thyroiditis. Pathol Res Pract. 1997;193:777–81.

    Article  CAS  Google Scholar 

  18. Apel RL, Asa SL, Chalvardjian A, LiVolsi VA. Intrathyroidal lymphoepithelial cysts of probable branchial origin. Hum Pathol. 1994;25:1238–42.

    Article  CAS  Google Scholar 

  19. Klubo-Gwiezdzinska J, Manes RP, Chia SH, Burman KD, Stathatos NA, Deeb ZE, et al. Ectopic cervical thyroid carcinoma—review of the literature with illustrative case series. J Clin Endocrinol Metab. 2011;96:2684–91. https://doi.org/10.1210/jc.2011-0611.

    Article  CAS  PubMed  Google Scholar 

  20. Choi YM, Kim TY, Song DE, Hong SJ, Jang EK, Jeon MJ, et al. Papillary thyroid carcinoma arising from a thyroglossal duct cyst: a single institution experience. Endocr J. 2013;60:665–70.

    Article  Google Scholar 

  21. Zizic M, Faquin W, Stephen AE, Kamani D, Nehme R, Slough CM, et al. Upper neck papillary thyroid cancer (UPTC): a new proposed term for the composite of thyroglossal duct cyst-associated papillary thyroid cancer, pyramidal lobe papillary thyroid cancer, and Delphian node papillary thyroid cancer metastasis. Laryngoscope. 2015;126:1709–14. https://doi.org/10.1002/lary.25824.

    Article  PubMed  Google Scholar 

  22. Thompson LDR, Herrera HB, Lau SK. Thyroglossal duct cyst carcinomas in pediatric patients: report of two cases with a comprehensive literature review. Head Neck Pathol. 2017;11:442–9. https://doi.org/10.1007/s12105-017-0807-0.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Thompson LDR, Herrera HB, Lau SK. Thyroglossal duct cyst carcinomas: a clinicopathologic series of 22 cases with staging recommendations. Head Neck Pathol. 2017;11:175–85. https://doi.org/10.1007/s12105-016-0757-y.

    Article  PubMed  Google Scholar 

  24. Danilovic DL, Marui S, Lima EU, Luiz AV, Brescia MD, Moyses RA, et al. Papillary carcinoma in thyroglossal duct cyst: role of fine needle aspiration and frozen section biopsy to guide surgical approach. Endocrine. 2014;46:160–3. https://doi.org/10.1007/s12020-014-0173-6.

    Article  CAS  PubMed  Google Scholar 

  25. Pellegriti G, Lumera G, Malandrino P, Latina A, Masucci R, Scollo C, et al. Thyroid cancer in thyroglossal duct cysts requires a specific approach due to its unpredictable extension. J Clin Endocrinol Metab. 2013;98:458–65. https://doi.org/10.1210/jc.2012-1952.

    Article  CAS  PubMed  Google Scholar 

  26. Bardales RH, Suhrland MJ, Korourian S, Schaefer RF, Hanna EY, Stanley MW. Cytologic findings in thyroglossal duct carcinoma. Am J Clin Pathol. 1996;106:615–9.

    Article  CAS  Google Scholar 

  27. Wenig BM. Atlas of head and neck pathology. 3rd ed. Philadelphia: Elsevier; 2015.

    Google Scholar 

  28. Kozol RA, Geelhoed GW, Flynn SD, Kinder B. Management of ectopic thyroid nodules. Surgery. 1993;114:1103–6.

    CAS  PubMed  Google Scholar 

  29. Nikiforov Y, Biddinger PW, Thompson LDR. Diagnostic pathology and molecular genetics of the thyroid. 2nd ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012.

    Google Scholar 

  30. Triantafyllou A, Williams MD, Angelos P, Shah JP, Westra WH, Hunt JL, et al. Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved? Eur Arch Otorhinolaryngol. 2015;273:2867–75. https://doi.org/10.1007/s00405-015-3786-3.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Gerard-Marchant R, Caillou B. Thyroid inclusions in cervical lymph nodes. Clin Endocrinol Metab. 1981;10:337–49.

    Article  CAS  Google Scholar 

  32. Leon X, Sancho FJ, Garcia J, Sanudo JR, Orus C, Quer M. Incidence and significance of clinically unsuspected thyroid tissue in lymph nodes found during neck dissection in head and neck carcinoma patients. Laryngoscope. 2005;115:470–4. https://doi.org/10.1097/01.mlg.0000157841.63283.87.

    Article  PubMed  Google Scholar 

  33. Meyer JS, Steinberg LS. Microscopically benign thyroid follicles in cervical lymph nodes. Serial section study of lymph node inclusions and entire thyroid gland in 5 cases. Cancer. 1969;24:302–11.

    Article  CAS  Google Scholar 

  34. Nicastri AD, Foote FW Jr, Frazell EL. Benign thyroid inclusions in cervical lymph nodes. JAMA. 1965;194:1–4.

    Article  CAS  Google Scholar 

  35. Lin DM, Javidiparsijani S, Vardouniotis A, Buckingham L, Reddy SB, Gattuso P. Ectopic thyroid tissue: Immunohistochemistry and molecular analysis. Appl Immunohistochem Mol Morphol. 2017; https://doi.org/10.1097/pai.0000000000000515.

  36. Lee YJ, Kim DW, Park HK, Ha TK, Kim DH, Jung SJ, et al. Benign intranodal thyroid tissue mimicking nodal metastasis in a patient with papillary thyroid carcinoma: A case report. Head Neck. 2015;37:E106–8. https://doi.org/10.1002/hed.23886.

    Article  PubMed  Google Scholar 

  37. Rodriguez J, Rosai J. Parasitic nodules of the thyroid. A metastasis simulator. A study of 76 cases. Lab Investig. 2006;86(Suppl 1):96A.

    Google Scholar 

  38. Rosai J, Kuhn E, Carcangiu ML. Pitfalls in thyroid tumour pathology. Histopathology. 2006;49:107–20. https://doi.org/10.1111/j.1365-2559.2006.02451.x.

    Article  CAS  PubMed  Google Scholar 

  39. Nasrallah MP, Pramick MR, Baloch ZW. Images in endocrine pathology: Parasitic nodule of thyroid in neck of patient with family history of papillary thyroid carcinoma. Endocr Pathol. 2015;26:273–5. https://doi.org/10.1007/s12022-014-9329-4.

    Article  PubMed  Google Scholar 

  40. Komorowski RA, Hanson GA. Occult thyroid pathology in the young adult: an autopsy study of 138 patients without clinical thyroid disease. Hum Pathol. 1988;19:689–96.

    Article  CAS  Google Scholar 

  41. Harach HR, Cabrera JA, Williams ED. Thyroid implants after surgery and blunt trauma. Ann Diagn Pathol. 2004;8:61–8.

    Article  Google Scholar 

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Correspondence to Andrey Bychkov .

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Bychkov, A. (2019). Thyroglossal Duct Cyst and Other Ectopic Thyroid Tissues in the Neck. In: Kakudo, K. (eds) Thyroid FNA Cytology. Springer, Singapore. https://doi.org/10.1007/978-981-13-1897-9_18

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  • DOI: https://doi.org/10.1007/978-981-13-1897-9_18

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