Diffuse Thyroid Enlargement Following Metastasis of Lung Adenocarcinoma

• Published in: Internal Medicine Vol. 54; no. 7; pp. 807 - 812
• Main Authors: Murakami, Takaaki, Taki, Masato, Nambu, Takuo, Wakasa, Tomoko, Kato, Tomoko, Matsuda, Yuki, Yonemitsu, Shin, Muro, Seiji, Oki, Shogo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2015
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - secondary; Adenocarcinoma of Lung; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biopsy, Fine-Needle; chyliform effusion; diffuse goiter; Fatal Outcome; fine-needle aspiration biopsy; Goiter - pathology; Humans; lung cancer; Lung Neoplasms - pathology; Lung Neoplasms - secondary; Male; Middle Aged; Radiopharmaceuticals; secondary thyroid tumor; Sensitivity and Specificity; Thyroglobulin - metabolism; thyroid metastases; Thyroid Neoplasms - secondary; Tomography, X-Ray Computed; Ultrasonography, Interventional
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.54.3742

A 55-year-old man presented with a rapidly enlarging thyroid. He had been diagnosed with lung adenocarcinoma nine months earlier. Computed tomography (CT) and ultrasound (US) detected reticular cord-like structures, but no nodules, in the thyroid. A fine-needle aspiration biopsy (FNAB) of the thyroid revealed thyroglobulin-negative adenocarcinoma cells, thus establishing the diagnosis of diffuse thyroid metastases of lung cancer. Moreover, the fluid demonstrated milky chyliform effusion. This case suggests that the presence of reticular cord-like structures on US and CT may be a key imaging finding for the clinical diagnosis of diffuse thyroid metastases and that chyliform effusion may contribute to rapid goiter formation.