Riedel's thyroiditis containing cytologically atypically appearing B-cells: a case report

Pathol Res Pract. 2003;199(7):497-501. doi: 10.1078/0344-0338-00453.

Abstract

We report on a case of Riedel's thyroiditis containing cytologically atypically appearing B-cells. The patient was a 60-year-old Japanese female, who had a well-demarcated tumor that showed extensive growth from the right thyroid lobe into perithyroidal soft tissues. Histologically, the lesion consisted of two components. The central tumor-like portion of the mass showed spindle cells intermixed with abundant collagen fibers. In addition, scattered B-cells with large nuclei and multiple small, but conspicuous nucleoli were also present. At the periphery of the nodule, numerous plasma cells and small lymphocytes, as well as occasional B-immunoblasts and plasmablasts were growing between non-neoplastic thyroid follicles. An infiltration of thyroid follicles by B-cells also resulted in lymphoepithelial-like lesions. The specimen obtained from an enlarged cervical lymph node occurring 14 months later contained numerous mature plasma cells showing a sheet-like arrangement with occasional immature plasma cells and immunoblasts in the interfollicular area and medullary cords. The polyclonal nature of B-cells was demonstrated immunohistochemically and by polymerase chain reaction in both the thyroid gland and the lymph node lesion.

Publication types

  • Case Reports

MeSH terms

  • B-Lymphocytes / metabolism
  • B-Lymphocytes / pathology*
  • Biomarkers, Tumor / analysis
  • Carcinoma / diagnosis
  • DNA, Neoplasm / analysis
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoenzyme Techniques
  • In Situ Hybridization
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / metabolism
  • Lymphoma, B-Cell / pathology*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / metabolism
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Middle Aged
  • Polymerase Chain Reaction
  • Thyroid Gland / metabolism
  • Thyroid Gland / pathology*
  • Thyroid Gland / surgery
  • Thyroid Neoplasms / diagnosis
  • Thyroiditis, Autoimmune / complications
  • Thyroiditis, Autoimmune / metabolism
  • Thyroiditis, Autoimmune / pathology*

Substances

  • Biomarkers, Tumor
  • DNA, Neoplasm