Intrathyroidal thymic tissue mimicking a thyroid nodule in a 4-year-old child

Cincinnati Children's Hospital Medical Center, Department of Radiology, 3333 Burnet Avenue, Cincinnati, OH 45229-3030.
Journal of Clinical Ultrasound (Impact Factor: 0.69). 06/2013; 41(5). DOI: 10.1002/jcu.21930
Source: PubMed


A 4 year-old girl was referred for CT of her neck for suspected submental lymphadenopathy and was found to have an incidental low-attenuation thyroid mass. Subsequent thyroid ultrasound showed a heterogeneous thyroid mass with punctate areas of increased echogenicity. Cytologic examination was consistent with ectopic intrathyroidal thymic nodule. We review the presentation of ectopic thymic tissue, especially in the thyroid gland. (c) 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 41:319320, 2013

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    • "Ectopic intrathyroidal thymic tissue is a rare congenital anomaly and most of the cases were found incidentally during surgery for thyroid nodule [1]. A few cases of ectopic intrathryoidal thymus have been reported so far [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11]. Most of the patients were children and two of the reported cases had intrathyroidal parathyroid gland surrounded by intrathyroidal ectopic thymic tissue within a single nodule [2] [3]. "
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    ABSTRACT: Ectopic intrathyroidal thymic tissue can form a mass lesion within the thyroid gland and has rarely been reported in children. We report a case of intrathyroidal thymus accompanied by an intrathyroidal parathyroid gland in a 29-year-old woman who visited our hospital due to right neck mass diagnosed as metastatic papillary carcinoma by aspiration cytology in an outside hospital. She had a history of right thyroidectomy due to papillary thyroid carcinoma three years ago. Ultrasonographic examination of the left thyroid gland showed a well-defined hyperechoic nodule, which did not show change in size compared with the previous study. She underwent complete thyroidectomy with right neck dissection. Grossly, the left thyroid had a well demarcated pale yellow nodule measuring 0.9 cm in diameter. On microscopic examination, the nodule was composed of mature fat tissue, ectopic thymic tissue with Hassall's corpuscles, and an intrathyroidal parathyroid gland. This is an exceedingly rare case of ectopic intrathyroidal thymus with intrathyroidal parathyroid gland, in an adult.
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    ABSTRACT: Ectopic intrathyroidal thymus is thought to be a rare entity, often discovered incidentally, and is due to aberrant thymic migration during embryogenesis. Objective´╝ÜThe aim of this study was to determine the prevalence of ectopic intrathyroidal thymus in children using ultrasound screening. This study was cross-sectional and conducted with the initial preliminary survey of the Fukushima Health Management Survey between October 9, 2011-March 31, 2012 after the Fukushima Daiichi Nuclear Power Plant accident. A total of 37,816 children were examined in the survey. Diagnostic criteria are on a basis of ultrasonographic appearances of ectopic intrathyroidal thymus, which were round, oval, or polygonal hypoechoic or hyperechoic areas, with multiple granular and punctate echogenic foci. We observed 375 (0.99%) cases (164 girls and 211 boys) with ectopic intrathyroidal thymus. The mean age was 7.0 years (range 0-18). Ectopic intrathyroidal thymus was located in the right (n=180), left (n=178) or bilateral (n=17) thyroid lobes. The incidence of ectopic intrathyroidal thymus was inversely correlated with age and body mass index (BMI). Our results reflect the prevalence of ectopic intrathyroidal thymus using ultrasonography in the general population. Further examination will be needed by way of longitudinal follow-up. .
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