International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 4, Issue 7 | Case Report | Open Access
Kavita Krishnan*
1Anatomic Pathologist and Head of Laboratory Services, Prime Healthcare, Dubai
2Specialist General Surgeon, Prime Hospital, Dubai
3Director, Diagnostic Services, Prime Healthcare, Dubai
*Correspondence to: Kavita Krishnan
Fulltext PDFWe report a rare case of concurrent Papillary Thyroid Carcinoma (PTC) and Follicular Lymphoma (FL) in a 44-year-old female, highlighting the importance of comprehensive evaluation in patients with malignancy to avoid missing a second primary or metastatic disease.
The patient, previously healthy, presented for routine breast cancer screening, during which a BIRADS 4 lesion was detected on MRI. A referral to a breast surgeon led to the incidental discovery of a right thyroid nodule. Ultrasound revealed a 1.9 cm nodule with microcalcifications and a 2.6 cm left supraclavicular lymph node with a distorted hilum. Further imaging (CT and PET-CT) identified hypermetabolic lymphadenopathy in the perigastric, left para-aortic, and peripancreatic regions. FNAC of the thyroid nodule confirmed PTC.
Following multidisciplinary discussion, excision biopsies of the supraclavicular and retroperitoneal lymph nodes were performed. Histopathology confirmed low-grade FL in both sites, supported by immunohistochemistry. Total thyroidectomy confirmed PTC (stage pT1b Nx), and postoperative radioiodine therapy was administered. Genetic analysis revealed no pathogenic mutations. FL was staged as at least Stage III, Grade 1, with no current indication for treatment per NCCN 2024 guidelines. The breast lesion was biopsied and subsequently excised. Histopathology confirmed it to be a benign intraductal papilloma.
Concurrent presentation of PTC and FL is exceedingly rare. Although previous reports have associated such presentations with EZH2 mutations, no such mutation was detected in this case. This report underscores the critical role of vigilant lymph node assessment and histological confirmation in malignancy cases to identify secondary primaries or metastases.
Kavita Krishnan, Verushka Mukesh Mansukhani, A Rare Synchronous Occurrence of Papillary Thyroid Carcinoma and Follicular Lymphoma: Case Report and Review of the Literature. Int Clinc Med Case Rep Jour. 2025;4(7):1-5.