Heterotopic parathyroid inclusion in a cervical lymph node.

Background: During the pathologic examination of neck dissection specimens, unexpected findings within the lymph nodes may be discovered. Such findings may include benign epithelial inclusions, a second primary tumor, or chronic inflammatory diseases.

Methods: We report a case of a 59-year-old man who underwent a laryngectomy and bilateral neck dissection for a right transglottic squamous carcinoma of the larynx. During the procedure, a large lymph node measuring 2.5 x 2.2 x 0.8 cm was found at the right level IV.

Results: Histologic examination of the neck dissection specimen revealed benign parathyroid inclusions in the enlarged lymph node. The heterotopic cells expressed parathyroid hormone. This case represents a unique example of heterotopic parathyroid inclusions in a cervical lymph node.

Conclusions: Parathyroid tissue should be included in the differential diagnosis of cervical intranodal epithelial inclusions.