Tall cell variant of papillary carcinoma coexisting with chronic lymphocytic thyroiditis - A case report

BACKGROUND: Recent studies have shown a correlation between lymphocytic thy roiditis and papillary carcinoma of the thyroid. It is thought that autoimm une thyroiditis could be a risk factor for the development of thyroid carci noma, mainly for the papillary variant. CASE: A 59-year-old female presented with It history of enlargement in the neck and Jive months of dysphagia. Clinical examination showed generalized expansion and an increase in the hardness of the thyroid gland. Hormonal ou tline showed subclinical hypothyroidism with serum levels of TSH slightly e levated (5 mu g/dL; range, 0.25-4). Thyroglobulin antibodies and thyroperox idase titers were moderately positive. Given these results, a diagnosis of chronic thyroiditis was made. Thyroid ultrasound scan showed diffuse gland irregularity and the presence of a solitary Module (2.3 cm in diameter) loc alized in the right lobe. Fine needle aspiration biopsy (FNAB) of the nodul e was performed under ultrasound guidance. CONCLUSION: Although clinical and laboratory results supported the diagnosi s of autoimmune thyroiditis only, FNAB of the nodular lesion provided evide nce of a rare case of papillary carcinoma, tall cell variant, confirmed by histologic results.