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