Sarcoid reaction in thyroid diseases: Report of a case of thyroid carcinoma demonstrating sarcoid reaction in regional lymph nodes

Abstract

We describe an extremely rare case of thyroid carcinoma accompanied by sarcoid reaction in regional lymph nodes. The patient, a 40-year-old woman, was found to have anterior neck swelling during a routine medical examination. Physical examination revealed a bad movable and firm nodule measuring 3.5 x 2.5 cm in the right thyroid lobe. Examination of a fine- needle aspiration cytology of the nodule suggested papillary carcinoma of class V. Right lobectomy and isthmectomy with neck dissection were performed. Histopathological examination of the resected specimens revealed papillary carcinoma accompanied by metastatic foci in right perithyroidal lymph nodes and non-caseous sarcoid-like granulomas in pretracheal, right upper internal deep cervical and submandibular lymph nodes. We concluded that these granulomas were due to a sarcoid reaction associated with thyroid carcinoma, after performing examinations to rule out the possibility of systemic sarcoidosis.