Résumé
La tumeur Warthin-like de la thyroïde est une variante rare du carcinome papillaire thyroïdien caractérisée par un stroma lymphoïde. Approximativement, 95 observations ont été publiées dans la littérature. Comme le carcinome papillaire, la tumeur Warthin-like de la thyroïde est une tumeur de bon pronostic. La clé du diagnostic est l’examen anatomopathologique. Nous rapportons le cas d’une femme de 61 ans qui consultait pour une tuméfaction basi-cervicale antérieure évoluant depuis 3 mois. L’échographie thyroïdienne objectivait un nodule hypoéchogène, isthmolobaire gauche, supra-centimétrique. A la scintigraphie, il s’agissait d’un nodule froid. L’examen macroscopique montrait un nodule juxta-isthmique de 2,5 cm de grand axe. A l’examen histologique, le nodule était constitué essentiellement de formations papillaires se projetant à l’intérieur d’une cavité kystique mêlées à quelques vésicules. Le stroma renfermait un infiltrat lymphoïde dense, souvent diffus. Les papilles et les vésicules étaient tapissées par des cellules oncocytaires présentant souvent les caractéristiques nucléaires du carcinome papillaire. Le diagnostic de tumeurWarthin-like de la thyroïde était retenu. Le but de ce travail était de dégager les caractéristiques cliniques, histologiques, immunohistochimiques ainsi que les diagnostics différentiels et le pronostic de cette entité rare.
Abstract
The Warthin-like tumour of the thyroid gland is a rare variant of thyroid papillary cell carcinoma characterized by a lymphoid stroma. Approximately, 95 cases have been published in the literature. As papillary carcinoma, Warthin-like tumor of the thyroid has a good prognosis. The key of diagnosis is the pathological pattern. We describe a 61 years old woman how presented a cervical swelling evolving since 3 months without signs of compression or thyroid dysfunction. Thyroid ultrasonography showed a multinodular thyroid with a left supracentimetric hypoechoic nodule. On sintigraphy, it was a cold nodule. -The macroscopic exam showed a juxta-isthmic, 2, 5 cm in diameter nodule. On histology, it was composed essentially of papillary formations inside a cystic cavity mingled with some follicules. The stroma was constituted of an abundant lymphoplasmocytic infiltrate. Tumour cells were oncocytic, presenting the nuclear features of papillary carcinoma. Pathological examination confirmed the diagnosis ofWarthin-like tumour of the thyroid gland. We aimed with this observation to focus on clinicopathological and evolutive features of this rare tumour and to discuss the differential diagnoses.
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Rekik, W., Khadhar, A., Zehani, A. et al. Tumeur Warthin-like de la thyroïde : à propos d’un cas. J Afr Cancer 7, 247–251 (2015). https://doi.org/10.1007/s12558-015-0392-7
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DOI: https://doi.org/10.1007/s12558-015-0392-7