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Background: We have reported three cases of incidental findings of solid cell nests, ectopic thymus with parathyroid tissue and thyrolipoma in thyroidectomy specimens. These patients presented clinically as nodular thyromegaly and were directed for FNAC. Ultrasound findings were suggestive of nodular goiter and on histopathology revealed features compatible with nodular goiter along with incidental findings of solid cell nests, ectopic thymus with parathyroid tissue and thyrolipoma. Differential diagnosis of thyroid nodules should include these rare diagnostic findings which create confusion in thyroid pathology as they mimic malignancies both clinically and histologically and also because neoplasms may arise in the background of these rare findings. Objectives: To analyze clinicopathological findings in thyroid specimens, to correlate with Ultrasonography (USG), Fine needle aspiration cytology (FNAC), hormonal assay and immunohistochemistry. Materials and methods: All the specimens were analyzed and routinely processed for histopathology and stained with haematoxylin and eosin. Results: Incidental associated findings were noted in three cases composed of solid cell nests, ectopic thymus with parathyroid tissue and thyrolipoma. Conclusion: Three incidental and relatively unusual findings of solid cell nests, ectopic thymus with parathyroid tissue and thyrolipoma were diagnosed on histopathology. These lesions of thyroid gland must be differentiated from close mimickers including both non-neoplastic and neoplastic lesions clinically, radiologically and microscopically. Though benign and rare, these incidental findings should be thought of in all the thyroid specimens to avoid confusion with neoplastic thyroid pathology and also because they carry a potential risk for developing into neoplastic lesions. [ABSTRACT FROM AUTHOR]

Abstract: Because thyrolipoma (adenolipoma of thyroid) and thyrolipomatosis (diffuse lipomatosis of thyroid) are distinctively rare conditions with only few cases reported in the literature, we are reporting 5 additional cases. All the 5 patients were adult females, with ages from 38 to 79 years, who presented with thyroid masses. Four of the patients had normal thyroid function tests and one had mild hypothyroidism. All patients received partial or total thyroidectomy. The thyroid specimens showed either circumscribed yellow-tan masses (cases 1, 2, and 3) or diffuse yellow-brown discoloration (cases 4 and 5). Histologic examination revealed abundant mature fat infiltrating the affected thyroid tissue in 3 distinct patterns: (1) fat infiltration limited to follicular adenomas (thyrolipoma); (2) fat diffusely infiltrating throughout the thyroid gland (thyrolipomatosis); or (3) fat infiltration involving both follicular adenoma and their surrounding thyroid tissue. Because of the rarity of thyroid fat-containing lesions, confusion in differential diagnosis may occasionally occur. It is important to be aware during frozen section that these lesions may present as extrathyroidal nodules, which can be radioactive on intraoperative scan for parathyroid glands. In addition, a papillary thyroid carcinoma was also identified in one case of thyrolipomatosis. All patients recovered well after surgery and there has been no recurrence of the lesions after 1 to 24 years of clinical follow-up. In summary, we are reporting 5 rare cases of thyrolipoma and thyrolipomatosis with distinct histologic patterns. Previously reported cases of thyrolipomatosis were reviewed and analyzed with the current cases. [Copyright &y& Elsevier]

The presence of adipocytes within thyroid glands is a rare finding seen in thyrolipoma, diffuse lipomatosis, or thyroid teratoma. Although some cases present with multinodular goiter or autoimmune thyroiditis, the exact cause has not yet been elucidated. Among reported cases, thyrolipomas mainly occur in females and usually present as a solitary lesion. However, a few reported cases had coexisting papillary thyroid carcinomas. Herein, we present a 51-year-old female with synchronous thyrolipoma (2.0 × 1.5 × 1.3 cm) and papillary thyroid carcinoma (0.7 × 0.6 × 0.6 cm) within the same thyroid lobe. She had diabetes mellitus and hypertension and complained of anterior neck enlargement and discomfort for three months. Thyroid sonography showed multiple hypoechoic nodules, one of which was heterogeneous and ill-defined. Fine needle aspirate cytology for the ill-defined nodule was suspicious for papillary thyroid carcinoma. She subsequently received radical thyroidectomy and neck lymph node dissection. Histopathologically, one thyrolipoma and one papillary thyroid carcinoma were identified in the right lobe of the thyroid gland without metastases of lymph nodes, while other nodules were multinodular goiter. Notably, thyrolipoma may not be simply an incidental finding but might coexist with thyroid carcinomas. A brief review of the pertinent literature of prior reports is also provided. [ABSTRACT FROM AUTHOR]