ABSTRACT
OBJECTIVE: To find out the frequency of Zuckerkandl Tubercle (ZT) and the position of recurrent laryngeal nerve with reference to ZK. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: Surgical Ward-3, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from June 2010 to August 2011. METHODOLOGY: Patients having goiter, aged between 12 - 60 years were admitted through OPD and operated after informed written consent. After admission, they underwent surgery. ZT and recurrent laryngeal nerve position i.e. whether medial, lateral or posterior to ZT was identified during surgery. Data was collected on pre-designed proforma and analysed on SPSS version 15 for descriptive statistics. RESULTS: Out of the 84 patients ZT was found in 52 (61.90%) patients. Nineteen patients had grade-I (less than 0.5 cm), 22 (42.3%) had grade-II (0.5 - 1 cm) and 11 (21.1%) had grade-III (more than 1 cm) ZT. During surgery, 33 (63.4%) patients had recurrent laryngeal nerve medial to ZT, 15 (28.8%) patients had lateral and in 4 (7.6%) patients recurrent laryngeal nerve was engraved posteriorly. CONCLUSION: Zuckerkandl tubercle was found in about 62% cases; recurrent laryngeal nerve was located pre-dominantly medial to ZT.
Subject(s)
Laryngeal Nerves/anatomy & histology , Para-Aortic Bodies/pathology , Parathyroid Glands/anatomy & histology , Recurrent Laryngeal Nerve/pathology , Thyroid Gland/anatomy & histology , Thyroid Neoplasms/surgery , Thyroidectomy/methods , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Intraoperative Complications/prevention & control , Laryngeal Nerve Injuries/prevention & control , Male , Middle Aged , Parathyroid Glands/pathology , Thyroid Gland/surgery , Thyroid Neoplasms/pathology , Young AdultABSTRACT
OBJECTIVE: To determine the frequency of tuberculous cervical lymphadenopathy mimicking metastasis from papillary thyroid cancer. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Surgical Unit-I, Ward-3 of Jinnah Postgraduate Medical Centre, Karachi, from March 2005 to March 2010. METHODOLOGY: All patients above 12 years of age of either gender diagnosed on investigations as papillary thyroid cancer (PTC) were included in the study. Ultrasound and fine needle aspiration cytology (FNAC), neck of solitary thyroid nodules (STN) and cervical lymph nodes were done. Total thyroidectomy and excision biopsy of cervical lymph nodes was performed, histopathological results were recorded and patients were managed accordingly. RESULTS: A total of 55 patients had PTC and 25 had cervical lymphadenopathy. Eighteen patients of PTC with cervical lymphadenopathy were diagnosed after investigations as cases of tuberculous cervical lymphadenopathy (TCL) initially considered as metastasis from PTC; 5 patients had metastasis from PTC. Two patients proved to be of reactive hyperplasia which initially showed tuberculous cervical lymphadenopathy on FNAC. So 80% patients of cervical lymphadenopathy with PTC were due to benign disease and 20% had metastasis in lymph node due to PTC. CONCLUSION: PTC with cervical lymphadenopathy due to co-existent tuberculosis is common. Metastasis from PTC in lymph nodes were less common than tuberculous lymphodenitis in this study. Tuberculosis should be considered before deciding for neck dissection in cases of PTC.
