Jeffery, Hannah;
Bosch, Karen D;
Brain, Caroline;
Kurzawinski, Tom;
Beale, Tim;
Kowa, Xin-Ying;
Aziz, Tarek Abdel;
(2025)
Significance of ectopic intrathyroidal thymic tissue detected on ultrasound in different paediatric age groups: a proposed classification to guide investigation and management.
European Journal of Pediatrics
, 184
, Article 284. 10.1007/s00431-025-06121-9.
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Abstract
Ectopic aberrant thymic tissue is most commonly found in the thyroid gland and is increasingly found incidentally due to the widespread use of ultrasound. Correct identification of this benign pathology on ultrasound can avoid the morbidity associated with fine needle aspiration (FNA) and anxiety associated with a possible cancer diagnosis. A case series of 21 children found to have likely intrathyroidal thymic tissue on ultrasound scan of the neck between 2013 and 2024 at the University College London Hospital. Twenty-one children aged between six months and ten years old, 52% male and 48% female. The scans were performed following referral for a neck lump or cervical lymphadenopathy (N = 15), sore throat/cough (N = 4), pre-thyroidectomy scan for a Multiple Endocrine Neoplasia 2 patient (N = 1), and post cystic hygroma excision routine scan (N = 1). These well-defined hypoechoic foci ranged in size from 3 to 14 mm and direct comparison to normal thymic tissue was possible in 19/21 (90%). Three patients (14%) went on to have FNA to rule out papillary thyroid cancer (PTC); other cases had interval scans at median six months to confirm stable appearances. Conclusion: All patients in our study with intrathyroidal ectopic thymic tissue were younger than 10 years. We suggest a tailored management approach based on the age at presentation, presence of clear thymic tissue for comparison and past/family history. Given that it is unlikely for such tissue to be present in older children, an FNA would be recommended to exclude underlying thyroid cancer in children over 14 years.
| Type: | Article |
|---|---|
| Title: | Significance of ectopic intrathyroidal thymic tissue detected on ultrasound in different paediatric age groups: a proposed classification to guide investigation and management |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00431-025-06121-9 |
| Publisher version: | https://doi.org/10.1007/s00431-025-06121-9 |
| Language: | English |
| Additional information: | © The Author(s), 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Thyroid, Thymus, Thyroid cancer. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10218141 |
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