Endocrine Abstracts

Introduction: Warthin-like thyroid tumor (WLPTC) is a rare variant of papillary thyroid carcinoma characterized by a lymphoid stroma. Approximately 95 observations have been published in the literature. Like papillary carcinoma, Warthin-like thyroid tumors have a good prognosis. The key to diagnosis is anatomopathological examination. In this regard, we report a case of WLPTC because of its rarity.

Observation: Patient aged 56, known diabetic for 6 years on Glucophage. She has been followed up since 2012 (10 years ago) for hypothyroidism of autoimmune origin, and it was not until 1 year ago that an ultrasound examination revealed a thyroid of heterogeneous hypoechoic echostructure, with the presence of two supra-central nodules (right and left), classified EU TIRADS 5. Cytopuncture strongly suggestive of carcinoma on thyroiditis. The patient underwent surgery 6 months later, consisting of total thyroidectomy with bilateral central lymph node curage. Anatomopathological examination of the right and left lobes showed a malignant tumour proliferation of epithelial nature and predominantly papillary architecture. The papillae were of variable size, with a richly lymphocytic axis bordered by an epithelium of large polygonal cells with abundant granular eosinophilic cytoplasm, and enlarged nuclei with ground-glass chromatin and irregular incisure nuclear membranes. These nuclei show overlapping and moderate anisokaryosis. The stroma is squirrel-like and fibroinflammatory, with local calcospherites. This appearance corresponds to a papillary thyroid carcinoma variant warthin like class PT2m 0N+/22N, Mx. Six-month postoperative follow-up was without incidents.

Conclusion: The aim of this work is to outline the clinical, histological and immunohistochemical features, as well as the differential diagnoses and prognosis of this rare entity.