1. Thyroid tissue in in cervical lymph nodes

    I read with interest the Case Report "Cervical lymphadenopathy: metastasis of papillary carcinoma or ectopic thyroid tissue?", since I as a pathologist recently faced a similar diagnostic situation with only minimal thyroid tissue (less than 1 mm of size) in a cervical lymph node (neck dissection due to squamous cell carcinoma of the head and neck region).

    We classified the minimal amount of thyroid tissue as metastasis of a papillary thyroid carcinoma due to a definitive papillary morphology of the nuclei (nuclear grooves, Pseudoinclusions, ground glass appearance and nuclear overlapping). A subsequent histological examination of the surgical specimen of the entire thyroid gland revealed a papillary thyroid carcinoma of 0.8 cm.

    I would like to add one point to the discussion of this topic: even only minimal thyroid tissue in a cervical lymph node allows the diagnosis of metastasis (and not ectopic tissue) if a distinctive and classical papillary nuclear morphology is present.

    With kind regards, K.Schmitz

    Conflict of Interest:

    None declared

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