Medical cure of plasma cell granuloma of the thyroid associated with Hashimoto's thyroiditis: a case report and review.

Plasma cell granuloma (PCG) is a rare, benign inflammatory tumor composed of myofibroblasts, abundant plasma cells, and lymphocytes combined with collagen. A thyroid localization of PCG is extremely rare, and surgical therapy is indicated. We report the case of a 35-yr-old woman with a thyroid PCG, associated with Hashimoto's thyroiditis, that was responsible for tracheal compression. Surgery was performed, but the thyroid could not be removed because of the fibrotic process. The patient was treated with corticosteroids and immunosuppressive therapy. Dyspnea and dysphagia improved within 1 month, whereas thyroid volume returned to normal within 3 yr. We also review other reports of thyroid PCG in the literature and discuss the differential diagnosis and treatment. Although the use of immunosuppressive therapy has never been reported for thyroid PCG until now, this treatment may represent a good alternative to surgery in life-threatening, unresectable PCG.

[1]  L. Degroot,et al.  Painful Hashimoto's thyroiditis as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. , 2003, The Journal of clinical endocrinology and metabolism.

[2]  L. Gaido,et al.  Plasma Cell Granuloma of the Thyroid with Hashimoto's Thyroiditis: Report of a Rare Case , 2003, Ear, nose, & throat journal.

[3]  F. Martínez,et al.  Plasma cell granuloma of the thyroid. , 2002, Archives of pathology & laboratory medicine.

[4]  D. Valeyre,et al.  [Inflammatory pseudotumors of the lung with severe course]. , 2001, Revue des maladies respiratoires.

[5]  P. Flandroy,et al.  Extensive inflammatory pseudotumor of the pituitary. , 2001, The Journal of clinical endocrinology and metabolism.

[6]  J. L. Chong,et al.  A HARD THYROID MASS DUE TO PLASMA CELL GRANULOMA , 2001, International journal of clinical practice.

[7]  Louis P. Dehner,et al.  Extrapulmonary Inflammatory Myofibroblastic Tumor (Inflammatory Pseudotumor) A Clinicopathologic and Immunohistochemical Study of 84 Cases , 1995, The American journal of surgical pathology.

[8]  M. Bisceglia,et al.  Plasma cell granuloma of the thyroid associated with Hashimoto’s thyroiditis , 1995, Journal of endocrinological investigation.

[9]  M. Fujimura,et al.  Pulmonary plasma cell granuloma improves with corticosteroid therapy. , 1994, Chest.

[10]  M. Driessnack,et al.  Corticosteroids in the management of unresected plasma cell granuloma (inflammatory pseudotumor) of the lung. , 1991, Journal of pediatric surgery.

[11]  J. Coindre,et al.  Plasma cell granuloma of the adrenal gland and the thyroid: Report of two cases , 1989, Journal of surgical oncology.

[12]  Y. Finkelstein,et al.  Plasma cell granuloma of the thyroid gland , 1989, Head & neck.

[13]  L. Podoshin,et al.  Steroid therapy for plasma cell granuloma of the larynx. , 1988, Ear, nose, & throat journal.

[14]  T. Eimoto,et al.  Plasma cell granuloma of the lung--resection and steroid therapy. , 1987, The Thoracic and cardiovascular surgeon.

[15]  K. Chan,et al.  Plasma cell granuloma of the thyroid. , 1986, Journal of clinical pathology.

[16]  J. Schenken,et al.  Plasma cell granuloma of the thyroid. , 1985, Human pathology.

[17]  S. Holck.  Plasma cell granuloma of the thyroid , 1981, Cancer.

[18]  A. Liebow,et al.  Plasma cell granulomas of the lung , 1973, Cancer.

[19]  S. Mariotti,et al.  Autoimmune Thyroid Diseases , 2003 .

[20]  M. Mant,et al.  Plasma cell lesions of the thyroid: report of a case of solitary plasmacytoma and a review of the literature. , 1994, Thyroid : official journal of the American Thyroid Association.