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Case Reports in Otolaryngology
Volume 2016, Article ID 6469073, 5 pages
Case Report

Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers

1The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
2Division of Pediatric Hematology/Oncology, Hasbro Children’s Hospital, Providence, RI 02903, USA
3Department of Pathology, Rhode Island Hospital, Providence, RI 02903, USA
4Division of Otolaryngology, Hasbro Children’s Hospital, Providence, RI 02903, USA

Received 8 January 2016; Accepted 22 February 2016

Academic Editor: Yorihisa Orita

Copyright © 2016 Suresh Mohan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To describe the presentation and management of a child with Progressive Transformation of Germinal Centers (PTGC), an uncommon condition characterized by significant persistent lymphadenopathy, who developed papillary thyroid carcinoma and to explore and review potential links between PTGC and neoplastic processes in the head and neck. Methods. Case presentation and literature review are used. Results. A 10-year-old female presented with a right parotid mass and cervical lymphadenopathy. Multiple biopsies revealed PTGC without malignancy. Two years later, she developed fatigue and weight gain, and a thyroid nodule was found. Fine needle aspiration was strongly suggestive of papillary thyroid carcinoma. The patient underwent total thyroidectomy and central neck dissection without surgical management of the longstanding right lateral neck lymphadenopathy. Final pathology confirmed papillary thyroid carcinoma. She was treated with radioactive iodine therapy postoperatively and remains free of disease at three years of follow-up. Conclusions. PTGC is considered a benign condition but has previously been associated with Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL). This is the first reported case of papillary thyroid cancer in a child with preexisting cervical PTGC and no defined risk factors for thyroid malignancy. No link has been established with thyroid carcinoma, but patients with PTGC may have a defect in immune surveillance that predisposes them to malignancy.