Significance of thyroid tissue in lymph nodes associated with carcinoma of the head, neck or lung.

Abstract

Thyroid carcinoma was found unexpectedly in the thyroid gland or lymph nodes, at autopsy or in the surgical material removed from 22 patients with carcinoma of the head or neck region, or of the lung. Of 120 patients who had wide-field laryngectomy for squamous carcinoma of the head or neck, 6 (5%) had carcinoma in the portion of the thyroid gland removed at laryngectomy. Twenty of the 22 patients had mixed papillary and follicular or pure follicular thyroid carcinoma in the thyroid gland or lymph nodes and 2 had the solid type with amyloid stroma. Carcinoma was demonstrated in the thyroid glands of 15 of the 22 patients. Only a portion of the gland or none at all was removed from the other 7 patients and no primary carcinoma was demonstrated. Carcinoma was discovered, however, in every case in which the whole thyroid gland was available for study. Histologically, the metastases of mixed papillary and follicular carcinoma varied from predominantly papillary to predominantly follicular. The smaller the metastases, the more prominent were the follicles and the more normal was their appearance. From our observations, we believe that any thyroid tissue found in a lymph node represents metastatic thyroid cancer.