An uncommon variant, Warthin‑like papillary thyroid carcinoma: A case report

Abstract

The most prevalent form of thyroid cancer is papillary thyroid carcinoma, of which warthin-like papillary thyroid carcinoma (WLPTC) is an uncommon variant. The symptoms, diagnosis and course of treatment for this subtype of papillary thyroid cancer are comparable to those of the classic variety. It is usually associated with Hashimoto's thyroiditis and is considered to have a favourable prognosis. In the present case report, a 40-year-old female patient was presented with multiple thyroid nodules and subclinical hypothyroidism. The female patient underwent a total thyroidectomy after a fine needle aspiration biopsy revealed an atypia of undetermined significance in one of the nodules, along with a family history of thyroid cancer. The definitive pathological assessment revealed seven thyroid nodules with four different diagnoses, one of which was WLPTC.

Keywords: papillary thyroid carcinoma; thyroid carcinoma; thyroid nodule; warthin-like papillary thyroid carcinoma; warthin-like variant.

Figure 1

Microscopic findings of Warthin-like papillary carcinoma. (A) Oncocytic tumor cells lining the lymphocyte-rich stroma (H&E; magnification, x20). (B) Nuclear atypia findings specific to papillary carcinoma, such as nuclear enlargement, clarification, cleavage (arrowhead), and intranuclear pseudo-inclusion (arrow), are noteworthy (HEx40). (C) Positive HMBE1 immunohistochemical staining of tumor cells (magnification, x10). (D) Strong diffuse cytoplasmic immuno-expression of CK19 in tumor cells (magnification, x10).