Overview
It is characterized by papillary structures covered by oncocytic cells with typical PTC nuclear features and a dense lymphocytic infiltration of the stroma. Because it closely mimics Hashimoto's thyroiditis or conventional PTC on ultrasound and cytology, confirming a definitive diagnosis relies entirely on postoperative histopathology.
Key findings
Demographics: The study followed 6 patients (5 females and 1 male) with ages ranging from 23 to 54 years.
Universal Association: 100% of the patients had coexisting chronic lymphocytic (Hashimoto's) thyroiditis in the background.
Surgical Management: All patients underwent a total thyroidectomy as the primary treatment. Selective lymph node dissection was performed in 3 patients, revealing metastatic nodal disease in 2 of them.
Excellent Prognosis: Follow-up (averaging 1 year) showed 0% recurrence or residual disease, with all patients achieving completely normal postoperative thyroglobulin levels (<0.04 ng/mL).
Universal Association: 100% of the patients had coexisting chronic lymphocytic (Hashimoto's) thyroiditis in the background.
Surgical Management: All patients underwent a total thyroidectomy as the primary treatment. Selective lymph node dissection was performed in 3 patients, revealing metastatic nodal disease in 2 of them.
Excellent Prognosis: Follow-up (averaging 1 year) showed 0% recurrence or residual disease, with all patients achieving completely normal postoperative thyroglobulin levels (<0.04 ng/mL).
Why This Matters for Clinicians
Although regional lymph node metastasis is relatively common in WL-PTC (similar to classic PTC), the overall clinical course is highly indolent with an excellent prognosis. Recognizing this rare variant in pathology reports is vital to avoid diagnostic confusion and ensure appropriate, individualized patient management.