A 32 year old male presented with painless lymph node in the cervical region. Lymph node biopsy shown normal thyroid gland features. But clinically, on palpation, thyroid is normal the diagnosis is: (A) Papillary carcinoma of thyroid, (B) Lateral aberrant thyroid, (C) Follicular carcinoma of thyroid with metastatic lymphnodes, (D) None of the above
Answer is B. (B) Lateral aberrant thyroid # Clinical features of thyroid neoplasms> Small papillary tumours may be impalpable (occult carcinoma), even when lymphatic metastases are present (so-called lateral aberrant thyroid).> Pain, often referred to the ear, is frequent in infiltrating growths.# Papillary carcinoma> Spread to the lymph nodes is common, but blood-borne metastases are unusual unless the tumor is extrathyroidal.> Term extrathyroidal indicates that the primary tumour has infiltrated through the capsule of the thyroid gland.> Occult carcinoma> Papillary carcinoma may present as an enlarged lymph node in the jugular chain with no palpable abnormality of the thyroid.> Primary tumour may be no more than a few millimetres in size and is termed occult.> Such primary foci of papillary carcinoma may also be discovered in thyroid tissue resected for other reasons, for example Graves disease.> Term 'occult' is often applied to all papillary carcinomas less than 1.5 cm in diameter.> These have an excellent prognosis and are regarded as of little clinical significance.