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Case Reports
A Case of Carcinoma Showing Thymus-Like Differentiation (CASTLE) in the Thyroid.
Eun Hee Kim, Ji Yun Jeong, Eui Young Kim, Sang Ah Lee, Kyung Min Kim, Ji Hye Yim, Won Gu Kim, Tae Yong Kim, Sun A Kim, Gyungyup Gong, Young Kee Shong, Won Bae Kim
J Korean Endocr Soc. 2008;23(4):272-276.   Published online August 1, 2008
DOI: https://doi.org/10.3803/jkes.2008.23.4.272
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  • 24 Download
  • 2 Crossref
AbstractAbstract PDF
Carcinoma Showing Thymus-Like Differentiation (CASTLE) is a very rare malignant neoplasm of the thyroid, and this resembles lymphoepithelioma or squamous cell carcinoma of the thymus. It originates from ectopic thymic tissue or remnants of the branchial pouches. We recently experienced a case of CASTLE in the thyroid gland of a 61-year-old woman. She presented with an asymptomatic mass in the right thyroid gland and she was diagnosed with 'poorly differentiated carcinoma' of the thyroid by fine needle aspiration cytology (FNAC). Total thyroidectomy was performed for both diagnostic and therapeutic purposes. Histologic examination of the resected tumor showed that the tumor was lobulated with expanding fibrous bands, and it was infiltrated by lymphocytes and plasma cells. The tumor cells had oval, large vesicular nuclei and prominent nucleoli, and the immunohistochemical staining was positive for CD5 and bcl-2, so the patient was diagnosed with thyroid CASTLE. We report here on a case of CASTLE in the thyroid gland treated by surgery and external neck radiation therapy.

Citations

Citations to this article as recorded by  
  • Intrathyroidal thymic carcinoma exhibiting neuroendocrine differentiation: Case report with cytomorphology, immunocytochemistry, and review of the literature focusing on cytology
    Wen‐hao Ren, Kun Dong, Xiao‐zheng Huang, Yan‐li Zhu
    Diagnostic Cytopathology.2019; 47(11): 1197.     CrossRef
  • Cytologic Findings of Thyroid Carcinoma Showing Thymus-like Differentiation: A Case Report
    Sunhee Chang, Mee Joo, Hanseong Kim
    Korean Journal of Pathology.2012; 46(3): 302.     CrossRef
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Mediastinal Uptake Misinterpreted as Metastasis in Papillary Thyroid Cancer.
Eun Kyung Lee, Kyung Won Kim, So Yeon Park, Young Joo Park, Young Tae Kim, June Key Chung, Hwa Young Cho, Yun Hyi Ku, Hee Suk Min, Seong Hoe Park, Do Joon Park, Bo Youn Cho
J Korean Endocr Soc. 2007;22(6):460-464.   Published online December 1, 2007
DOI: https://doi.org/10.3803/jkes.2007.22.6.460
  • 2,487 View
  • 23 Download
  • 1 Crossref
AbstractAbstract PDF
Radioactive iodine (RAI) therapy is used for the removal of remnant thyroid tissue or metastatic thyroid cancer cells in differentiated thyroid cancer. The main mechanism of the therapy is destruction of cells by radioactive iodine that penetrates the cells though the action of the sodium-iodide symporter (NIS). We experienced a case of a 26-year-old woman with mediastinal uptake as detected on a radioiodine scan, who was previously diagnosed with papillary thyroid cancer. For diagnostic tests including chest computed tomography (CT) and a radioiodine scan, the stimulated thyroglobulin level did not show a definite cause of the mediastinal uptake. During regular follow-up, the thymus became triangular with clear margins. The patient had neither specific symptoms nor physical findings related to the presence of a thymic mass. A subsequent CT scan showed an irregular margin of the thymus, suggestive of thymic metastasis. The patient underwent a mediastinectomy. The removed specimen was composed of normal thymic tissue. Moreover, we demonstrated the presence of human NIS by immunohistochemical analysis. After thymectomy, the mediastinal uptake was markedly decreased as compared to the previous scan. This case suggests that a clinician should be suspicious for the functional uptake of thymus when metastasis is unlikely in a clinical situation.

Citations

Citations to this article as recorded by  
  • Clinical Significance of Diffuse Intrathoracic Uptake on Post-Therapy I-131 Scans in Thyroid Cancer Patients
    Hyun Su Choi, Sung Hoon Kim, Sonya Youngju Park, Hye Lim Park, Ye Young Seo, Woo Hee Choi
    Nuclear Medicine and Molecular Imaging.2014; 48(1): 63.     CrossRef
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