Abstract
A path taken by the developing thyroid during embryogenesis determines a wide area in the anterior neck, which may harbor ectopic thyroid remnants. The most common entity, which requires attention of pathologist, is a thyroglossal duct (TGD) cyst. This midline neck developmental lesion is diagnosed by the presence of epithelial lining and thyroid follicles. Rarely follicular epithelium in the wall of TGD cyst may undergo malignant transformation, giving rise to papillary thyroid carcinoma. Fine-needle aspiration findings in TGD are well described; however utility of cytologic examination is controversial due to low sensitivity. The major indication for fine-needle aspiration is evaluation of suspicious TGD cysts, when cytology may yield atypical cells with characteristic features of papillary carcinoma. Various kinds of microscopic thyroid inclusions accidentally found in the cervical region are important in the context of differential diagnosis with metastatic thyroid cancer. Meticulous search for primary thyroid tumor is a rule of thumb in such a challenging situation.
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