Solid Cell Nests Within a Parathyroid Gland\u2014Report of an Exceptional Case

Abstract

The ultimobranchial body (UBB) denotes the cellular mass originating from the fourth branchial pouch, which migrates from the neural crest and infolds within the middle and upper poles of the thyroid lobes, thereby establishing the presence of calcitonin-secreting parafollicular C cells. In various numbers, UBB remnants (entitled “solid cell nests”, or SCNs) are found in thyroid glands examined histologically. However, despite the close embryological relation between the UBB and the superior parathyroid glands, intraparathyroidal SCNs have to our knowledge not been previously reported. Here, we describe a patient presenting with a papillary thyroid carcinoma with central and lateral lymph node metastases. Upon postoperative analysis, an unintentionally removed parathyroid gland was observed adjacent to the superior aspect of the right thyroid lobe. Within a 0.6 × 0.5-mm area of the parathyroid gland, solid nests composed of epithelial cells with oval and slightly elongated nuclei were seen. The cells were positive for p40, p63, and GATA3, but negative for PTH. The final diagnosis was a SCN entrapped within the parathyroid gland. Empirically, we have not previously observed SCNs within the parathyroid glands. To our knowledge, our finding thus constitutes a very unusual histological manifestation, and could indicate an underlying aberrancy during embryogenesis given the close anatomical relationship between the UBB and the superior parathyroid glands.