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Benign Thyroid Inclusions in Cervical Lymph Nodes: Incidental finding of thyroid tissue within cervical lymph nodes turns out to be metastases from occult papillary thyroid carcinoma (PTC) in most cases. The discovery is usually made during pathologic assessment of neck dissections for non-thyroid cancers of upper aerodigestive tract.

However, bonafide cases of benign (ectopic) thyroid follicles within cervical lymph nodes do occur. Examination of the whole thyroid gland fails to reveal carcinoma in such cases. They usually consist of a small cluster of follicles, lacking any of the features of PTC, localized to the periphery of one or two cervical lymph nodes. If there is partial or total effacement of the nodal architecture by thyroid tissue, it is highly likely to be metastatic carcinoma.

Image courtesy of: Skip O. Cyte, MD (@skipocytes); used with permission.

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