Spindle cell variant of medullary thyroid carcinoma: a clinicopathologic study of four cases

Mapping Intimacies ◽

10.21203/rs.3.rs-290368/v1 ◽

2021 ◽

Author(s):

Yan Xia Wang ◽

Shoujing Yang

Keyword(s):

Thyroid Carcinoma ◽

Spindle Cell ◽

Regional Lymph Node ◽

Fibrous Stroma ◽

Immunohistochemical Markers ◽

Clinicopathologic Study ◽

Regional Lymph Node Dissection ◽

Special Morphology ◽

Cell Variant ◽

Thyroid Malignancies

Abstract BackgroundMedullary thyroid carcinoma (MTC) is a malignant tumor derived from C cells. It accounts for about 10% of all thyroid malignancies. More than 14 histological variants have been described. Among them, spindle cell variant is extremely rare.Case presentationHere we describe 4 cases of spindle cell variant of MTC collected from 2012 to 2019. Ultrasound showed solid and hypoechoic nodules. Three patients underwent total thyroidectomy and regional lymph node dissection, and 1 patient underwent thyroid mass resection. Histologically, the tumors showed spindle shaped cells in bundles or interlaced arrangement, separated by hyalinised fibrous stroma that contained amyloid deposits. Immunohistochemistry showed that the tumor cells were positive for calcitonin, chromogranin A, synaptophysin, CD56, and TTF-1, but negative for other lineage-specific markers.ConclusionsWe report 4 rare cases of spindle cell variant of MTC. Due to its rarity and special morphology, the diagnosis of spindle cell variant MTC relies on its morphology and immunohistochemical markers to avoid misdiagnosis.

Download Full-text

Spindle cell variant of medullary thyroid carcinoma: a clinicopathologic study of four cases

Diagnostic Pathology ◽

10.1186/s13000-021-01152-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yan Xia Wang ◽

Shou Jing Yang

Keyword(s):

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Spindle Cell ◽

Regional Lymph Node ◽

Medullary Thyroid ◽

Fibrous Stroma ◽

Immunohistochemical Markers ◽

Clinicopathologic Study ◽

Regional Lymph Node Dissection ◽

Cell Variant

Abstract Background Medullary thyroid carcinoma (MTC) is a malignant tumor derived from C cells. It accounts for about 10% of all thyroid malignancies. More than 14 histological variants have been described. Among them, spindle cell variant is extremely rare. Case presentation Here we describe 4 cases of spindle cell variant of MTC collected from 2012 to 2019. Ultrasound showed solid and hypoechoic nodules. Three patients underwent total thyroidectomy and regional lymph node dissection, and 1 patient underwent thyroid mass resection. Histologically, the tumors showed spindle shaped cells in bundles or interlaced arrangement, separated by hyalinised fibrous stroma that contained amyloid deposits. Immunohistochemistry showed that the tumor cells were positive for calcitonin, chromogranin A, synaptophysin, CD56, and TTF-1, but negative for other lineage-specific markers. Conclusions We report 4 rare cases of spindle cell variant of MTC. Due to its rarity and special morphology, the diagnosis of spindle cell variant MTC relies on its morphology and immunohistochemical markers to avoid misdiagnosis.

Download Full-text

Anaplastic carcinoma of the thyroid - clinicomorphological spectrum and review of literature

Journal of Pathology of Nepal ◽

10.3126/jpn.v1i1.4451 ◽

1970 ◽

Vol 1 (1) ◽

pp. 45-48 ◽

Cited By ~ 1

Author(s):

A Ghosh ◽

N Nepal ◽

MD Gharti ◽

S Basnet ◽

M Baxi ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Spindle Cell ◽

Neck Mass ◽

Anaplastic Thyroid Carcinoma ◽

Anaplastic Carcinoma ◽

High Power Field ◽

The Mean ◽

Cell Variant ◽

Thyroid Malignancies ◽

Atypical Mitosis

Background: Thyroid cancer is fairly common. The worldwide annual incidence ranges from 0.5 to 10 cases per 100,000 people. Anaplastic thyroid carcinoma, comprising less than 10% of all thyroid carcinomas, remains one of the most virulent of all cancers in humans with a 10 year survival rate of only 0.1 %. In the present study we looked into the clinical, cytological and histological spectrum of anaplastic carcinoma and compared our experience with recent literature. Materials and Methods: This was a hospital based retrospective study from January 2000 to November 2010. Clinical, cytological and histopathological data of all the diagnosed anaplastic thyroid carcinoma cases were reviewed and analyzed. Results: Of the 59 thyroid malignancies diagnosed in the same period, 7 cases were anaplastic carcinoma. The mean age was 63 years and was predominantly found in females. All of the cases presented with a neck mass that lasted for a mean of 5.7 months. The mean tumor size was 14.9 cm and the most common sub-type was the spindle cell type. Atypical mitosis of more than 5 per high power field and necrosis was noted in all cases. Conclusion: Due to the markedly aggressive nature of this tumor and its association with areas of endemic thyroid disease, early diagnosis and aggressive therapy is essential, especially in the Himalayan and Sub-Himalayan belt. Keywords: Anaplastic carcinoma; Thyroid carcinoma; Spindle cell variant DOI: 10.3126/jpn.v1i1.4451 Journal of Pathology of Nepal (2011) Vol.1, 45-48

Download Full-text

Role of Immunohistochemistry in Diagnosis of Papillary Thyroid Carcinoma: The Use of Ck19, CD56, P63 and CD117

Journal of Cancer and Tumor International ◽

10.9734/jcti/2019/v9i130097 ◽

2019 ◽

pp. 1-11

Author(s):

Azza Abdel-Aziz ◽

Dina Abdallah

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Diagnostic Accuracy ◽

Papillary Thyroid ◽

Diagnostic Dilemma ◽

Thyroid Lesion ◽

Immunohistochemical Markers ◽

Significant Difference ◽

Thyroid Malignancies ◽

Thyroid Lesions

Objective: Papillary thyroid carcinoma (PTC) is the most frequent histologic type of all thyroid malignancies. The presence of characteristic nuclear changes focally in a thyroid lesion may cause diagnostic dilemma. Immunohistochemistry may be helpful in the diagnosis of PTC yet not conclusive. The aim of this study is to test the applicability immunohistochemical markers; CK19, P63, CD56 and CD117 in distinguishing PTC from other follicular thyroid. Methods: Fifty nine cases of unequivocal diagnosis were selected to be rolled in our study; 24 papillary carcinoma cases and 35 cases representing other follicular throid lesions. Immunohistological studies include CK19, P63, CD56 and CD117. Subsequent statistical analysis of immunohistochemical data in relation to diagnosis was performed. Results: The diagnosis of PTC was significantly associated with Strong diffuse Ck19 expression, P63 expression and negative CD56 in relation to studied non PTC follicular thyroid lesions. On the other hand, CD117 was negative in most of the studied thyroid lesions with no significant difference between PTC and other lesions. CK19 was the most sensitive marker (91.2%) and P63 was the most specific one (87.5%), with better specificity in combining markers. Expression of CK19 and lost CD56 provided 97.1% sensitivity and 91.2% diagnostic accuracy in differentiating PTC from other studied lesions. Conclusions: Immunohistochemical markers, Ck19, P63 and CD56 are helpful in diagnosis of PTC and their combination can further improve diagnostic accuracy. CD117 is of no value in the diagnosis of studied cases.

Download Full-text

Hepatic Metastases from the Spindle Cell Variant of Medullary Thyroid Carcinoma

Acta Cytologica ◽

10.1159/000328348 ◽

2001 ◽

Vol 45 (6) ◽

pp. 1022-1026 ◽

Cited By ~ 6

Author(s):

Carolina Ibarrola de Andrés ◽

Victor Manuel Castellano Megías ◽

Claudio Ballestin Carcavilla ◽

Nuria Alberti Masgrau ◽

Andrés Perez Barrios ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Spindle Cell ◽

Hepatic Metastases ◽

Medullary Thyroid ◽

Cell Variant

Download Full-text

Thyroid Carcinoma Showing Thymic-Like Differentiation Causing Fracture of the Trachea

Case Reports in Medicine ◽

10.1155/2016/7962385 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Aikaterini Marini ◽

Meletios Kanakis ◽

Konstantinos Valakis ◽

Nikolaos Laschos ◽

Maria Chorti ◽

...

Keyword(s):

Lymph Node ◽

Thyroid Gland ◽

Thyroid Carcinoma ◽

Lymph Node Dissection ◽

Regional Lymph Node ◽

Node Dissection ◽

En Bloc ◽

Thymic Tissue ◽

Regional Lymph Node Dissection ◽

The Right

Thyroid carcinoma showing thymic-like differentiation (CASTLE) comprises a rare neoplasm of the thyroid gland which arises from ectopic thymic tissue or remnants of brachial pouches. CASTLE is regarded as an indolent neoplasm with a favorable prognosis, irrespective of its metastatic potential. Diagnosis is difficult as clinicopathological features have not been yet well-defined. Radiological findings are not specific and only immunohistochemical positivity for CD5 and CD117 staining is highly suggestive of CASTLE. Despite lack of universally accepted treatment recommendations, the mainstay treatment includes thyroidectomy and systematic lymph node dissection. We report a case of CASTLE tumour with very uncommon characteristics developed in a 76-year-old man, who presented with rapidly deteriorating dyspnea and severe cough, resulting in respiratory failure. At surgery, a suspicious looking tumour arising from the upper pole of the right lobe of the thyroid gland, surrounding the trachea and displacing the right common carotid artery, was identified. The patient underwent en bloc resection of the tumour with the thyroid gland and regional lymph node dissection. This is the first reported case of CASTLE causing tracheal ring fracture.

Download Full-text

Spindle cell variant of papillary thyroid carcinoma

Histopathology ◽

10.1111/j.1365-2559.2004.01916.x ◽

2004 ◽

Vol 45 (4) ◽

pp. 424-427 ◽

Cited By ~ 10

Author(s):

C Woenckhaus ◽

J Cameselle-Teijeiro ◽

C Ruiz-Ponte ◽

I Abdulkader ◽

R Reyes-Santias ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Spindle Cell ◽

Papillary Thyroid ◽

Cell Variant

Download Full-text

Surgical Management of Thyroid Carcinoma

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2005.0022 ◽

2005 ◽

Vol 3 (3) ◽

pp. 458-466 ◽

Cited By ~ 14

Author(s):

Maria A. Kouvaraki ◽

Suzanne E. Shapiro ◽

Jeffrey E. Lee ◽

Douglas B. Evans ◽

Nancy D. Perrier

Keyword(s):

Thyroid Carcinoma ◽

Distant Metastasis ◽

Regional Lymph Node ◽

Preoperative Staging ◽

Disease Recurrence ◽

Needle Aspiration ◽

Differentiated Thyroid Carcinoma ◽

Regional Lymph Nodes ◽

Regional Lymph Node Dissection ◽

Cervical Surgery

Thyroid carcinoma has a unique biologic behavior characterized by early spread to regional lymph nodes and occasional extrathyroidal soft tissue extension but a low incidence of distant metastasis and infrequent disease-related death. Therefore, controversy exists over the proper extent of thyroidectomy and regional lymph node dissection in patients with differentiated thyroid carcinoma (DTC) and medullary thyroid carcinoma (MTC). The modest disease-specific mortality makes it unlikely that the extent of surgery will ever be the subject of a prospective randomized trial. Although more extensive cervical surgery may have only a limited effect on the duration of survival in patients with DTC, it may significantly improve quality of life by minimizing cervical recurrence. The high rates of cervical recurrence in patients with DTC and MTC have alerted physicians to the importance of fine-needle aspiration biopsy and ultrasonography for the diagnosis, preoperative staging, and follow-up of thyroid cancer. In patients with MTC, death caused by disease is uncommon in the absence of radiographically evident distant metastasis at the time of thyroidectomy. Cervical recurrence is even more common with MTC, and the need for compartment-oriented lymphadenectomy is accepted as standard surgical treatment to minimize disease recurrence. Postoperatively, calcitonin (CT) levels can be used to guide clinical management, but basal CT levels should not be used to direct the timing of prophylactic thyroidectomy in affected high-risk patients with familial MTC.

Download Full-text