Plasma Cell Granuloma of the Thyroid and Hashimoto Thyroiditis
Plasma Cell Granuloma of the Thyroid and Hashimoto Thyroiditis
Plasma cell granuloma of the thyroid is a rare tumor-like lesion formed by a localized proliferation of inflammatory cells, supported by a stroma of fibrous tissue. Few cases have been previously reported in the medical literature. We report a new case of a 41-year-old man presenting a goiter with primary hypothyroidism (thyroid-stimulating hormone, 70 mIU/L; free thyroxine, < 0.01 pmol/L; triiodothyronine, 0.66 nmol/L) and elevation of thyroid antibodies. Several fine-needle aspiration biopsies of the thyroid were fruitless and total thyroidectomy was performed. Histologic and immunohistochemical study demonstrated the polyclonal nature of the cells and yielded a diagnosis of plasma cell granuloma. Histologic findings of Hashimoto thyroiditis were present too.
Plasma cell granuloma (PCG), also called inflammatory pseudotumor, is an infrequent disease. It is a nonneoplastic lesion histologically established by a localized proliferation of mature plasma cells, intermingled with lymphocytes and other inflammatory cells, supported by stroma of fibrous tissue. PCG was initially described in the lung by Bahadori and Liebow. The lung is the organ most often affected, although a number of cases have sporadically been reported in different extrapulmonary sites: liver, stomach, pancreas, spleen, kidney, bladder, heart, tonsil, spinal cord, meninges, and brain. The source of this disease is unknown. It is usually benign and has a good prognosis except in the rare cases in which vital structures have been affected and their function compromised.
Thyroid PCG is a rare condition. The first case demonstrated and confirmed by the immunoperoxidase staining technique did not appear until 1981. Until now, few cases have been reported in English language journals, more frequently in women. This case shows the coexistence of thyroid PCG and Hashimoto thyroiditis in a man.
Plasma cell granuloma of the thyroid is a rare tumor-like lesion formed by a localized proliferation of inflammatory cells, supported by a stroma of fibrous tissue. Few cases have been previously reported in the medical literature. We report a new case of a 41-year-old man presenting a goiter with primary hypothyroidism (thyroid-stimulating hormone, 70 mIU/L; free thyroxine, < 0.01 pmol/L; triiodothyronine, 0.66 nmol/L) and elevation of thyroid antibodies. Several fine-needle aspiration biopsies of the thyroid were fruitless and total thyroidectomy was performed. Histologic and immunohistochemical study demonstrated the polyclonal nature of the cells and yielded a diagnosis of plasma cell granuloma. Histologic findings of Hashimoto thyroiditis were present too.
Plasma cell granuloma (PCG), also called inflammatory pseudotumor, is an infrequent disease. It is a nonneoplastic lesion histologically established by a localized proliferation of mature plasma cells, intermingled with lymphocytes and other inflammatory cells, supported by stroma of fibrous tissue. PCG was initially described in the lung by Bahadori and Liebow. The lung is the organ most often affected, although a number of cases have sporadically been reported in different extrapulmonary sites: liver, stomach, pancreas, spleen, kidney, bladder, heart, tonsil, spinal cord, meninges, and brain. The source of this disease is unknown. It is usually benign and has a good prognosis except in the rare cases in which vital structures have been affected and their function compromised.
Thyroid PCG is a rare condition. The first case demonstrated and confirmed by the immunoperoxidase staining technique did not appear until 1981. Until now, few cases have been reported in English language journals, more frequently in women. This case shows the coexistence of thyroid PCG and Hashimoto thyroiditis in a man.
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