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Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved?

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Abstract

The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over normal-looking, nodal, thyroid follicles. Arguments for and against the benign nature of these follicles are considered together with processes that could be involved in their formation. The admittedly limited evidence suggests that benign, thyroid follicular inclusions rarely occur in cervical lymph nodes. Histological criteria that could be helpful in recognizing the inclusions, which include assessing their extent in conjunction with the size of the node, are discussed. Finally, an algorithm based on collaboration between specialists, correlating histological findings with imaging and loco-regional control of the upper aero-digestive tract cancer, is suggested for the management of patients with incidentally discovered, nodal thyroid tissue.

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Acknowledgments

The authors are grateful to Dr. E. Leon Barnes for insightful comments.

Author information

Authors and Affiliations

  1. Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK

    Asterios Triantafyllou

  2. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michelle D. Williams

  3. Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA

    Peter Angelos

  4. Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jatin P. Shah

  5. Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    William H. Westra

  6. Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Jennifer L. Hunt

  7. Department of Pathology, Allegiance Health, Jackson, MI, USA

    Kenneth O. Devaney

  8. University of Udine School of Medicine, Udine, Italy

    Alessandra Rinaldo

  9. Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Pieter J. Slootweg

  10. University Pathologists, Providence, RI and Fall River, MA, USA

    Douglas R. Gnepp

  11. Departments of Surgery and Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Carl Silver

  12. Coordinator of the International Head and Neck Scientific Group, Padua, Italy

    Alfio Ferlito

Authors
  1. Asterios Triantafyllou
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  2. Michelle D. Williams
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  3. Peter Angelos
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  4. Jatin P. Shah
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  5. William H. Westra
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  6. Jennifer L. Hunt
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  7. Kenneth O. Devaney
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  8. Alessandra Rinaldo
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  9. Pieter J. Slootweg
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  10. Douglas R. Gnepp
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  11. Carl Silver
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  12. Alfio Ferlito
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Corresponding author

Correspondence to Alfio Ferlito.

Additional information

This paper was written by members of the International Head and Neck Scientific Group (http://www.IHNSG.com).

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Triantafyllou, A., Williams, M.D., Angelos, P. et al. Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved?. Eur Arch Otorhinolaryngol 273, 2867–2875 (2016). https://doi.org/10.1007/s00405-015-3786-3

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  • DOI: https://doi.org/10.1007/s00405-015-3786-3

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