2024 Volume 55 Issue 4 Pages 105-110
The patient was a woman in her 60s. The patient was taking levothyrosine sodium orally for hypo thyroidism. She developed rapid left neck swelling accompanied by breathing difficulty, and was referred to our department for further investigation and treatment. Ultrasound findings showed a dotted hyperechoic image in the left lobe of the thyroid gland and a posterior enhancement area on the dorsal side, and we suspected internal bleeding in the thyroid cyst and performed fine-needle aspiration cytology.
The aspirate was yellowish-white and cloudy, and cytology revealed orange G-loving keratinized epithelial cells with mild nuclear atypia, making the diagnosis of atypical squamous cells. No malignant findings were found, and the patient was kept under observation, but the tumor gradually grew and the trachea was compressed, so left thyroid lobectomy was performed.
Pathological findings revealed a multilocular cyst with thick fibrous walls, the inner surface of the cyst was lined with squamous epithelium, and lymphoid tissue developed in the cyst wall. Immunostaining revealed that PAX-8 was expressed in the squamous epithelium, leading to a diagnosis of thyroid lymphoid follicular epithelioma.
It is a relatively rare cystic lesion of the neck. We report a case of thyroid lymphoepithelial cyst in which we had difficulty in diagnose.
