Description
Clinical History
A 68-year old woman presented with a small hard lump in the thyroid. During the following six weeks, there was progressive rapid enlargement of the mass leading to laryngeal stridor and oesophageal obstruction, which were the terminal features. No lymph nodes were enlarged and there was no splenomegaly.
Pathology
The larynx, thyroid, upper trachea and oesophagus are included in the specimen. The enlarged left lobe and to a lesser degree, the right lobe of the thyroid, are replaced by homogeneous pale tumor tissue. Stretched over the lateral margin of the left lobe is the common carotid artery. Note on the internal aspect how the larynx is compressed and the oesophagus virtually disappears into the bulk of the tumor. The histological appearance of the tumor was consistent with lymphoblastic lymphoma of the thyroid. The rarity of this tumor makes it necessary to exclude the diagnosis of anaplastic carcinoma of the thyroid, and secondary spread from lymphoma elsewhere.
Further Information
Primary lymphoma of the thyroid is rare but should always be considered as a differential diagnosis of any thyroid mass or nodule. Primary thyroid lymphomas are rare, and are usually of the non-Hodgkin type. Lymphoblastic lymphoma is an aggressive form of non-Hodgkin's lymphoma (NHL), usually seen in children. Currently, the only known risk factor for developing primary thyroid lymphoma is chronic autoimmune (Hashimoto's) thyroiditis, with a 50% occurrence rate.
Thyroid lymphoma should be considered in any individual presenting with a rapidly enlarging goiter, as over 90% of individuals with this disease present this way. As the goiter enlarges, there can be compression of nearby structures such as the trachea, oesophagus and neck vessels (the common carotid in this case). The resulting symptoms include stridor or hoarseness, dysphagia and neck pain. Other systemic symptoms of lymphoma include so-called B-symptoms, i.e. night sweats, fevers and loss of weight.
Diagnosis can be achieved by an ultrasound scan followed by fine needle aspiration or excisional biopsy. As thyroid lymphomas cannot be excluded from Hashimoto's or other carcinoma, cytology and immunohistochemical stain of the biopsied tissue is required to confirm the diagnosis.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
