Cribriform-morular variant of papillary thyroid carcinoma: molecular characterization of a case with neuroendocrine differentiation and aggressive behavior.
Menasce, Lia P
Yap, Beng K
Colaco, Rovel J
AffiliationDepartment of Pathology, Clinical University Hospital, Galician Health Service, University of Santiago de Compostela, Santiago de Compostela, Spain.
MetadataShow full item record
AbstractWe describe an especially aggressive case of cribriform-morular variant (C-MV) of papillary thyroid carcinoma (PTC) in a 42-year-old man with familial adenomatous polyposis who died with lung and brain metastases 17 months after thyroidectomy. The angioinvasive neoplasm combined a mixture of trabecular, solid, cribriform, and follicular patterns of growth with CD10+ morules. Follicles were devoid of colloid, and the nuclear features typical of PTC were present in some areas and missing in others. Tumor cells were positive for thyroid transcription factor-1 and, in 40% of the tumoral mass, also were positive for chromogranin and synaptophysin and were negative for thyroglobulin and calcitonin. Strong nuclear staining for beta-catenin was found in all tumor cells, as was positivity for p53 and cyclin D1. In addition to the germline heterozygous APC Ex 2-3 duplication mutation, a somatic homozygous silent p. Thr1493Thr gene variant was found in the neoplastic cells along with RET/PTC rearrangement. This tumor represents the first case of C-MV of PTC showing neuroendocrine differentiation.
CitationCribriform-morular variant of papillary thyroid carcinoma: molecular characterization of a case with neuroendocrine differentiation and aggressive behavior. 2009, 131 (1):134-42 Am. J. Clin. Pathol.
JournalAmerican Journal of Clinical Pathology
- Somatic but not germline mutation of the APC gene in a case of cribriform-morular variant of papillary thyroid carcinoma.
- Authors: Cameselle-Teijeiro J, Ruiz-Ponte C, Loidi L, Suarez-Peñaranda J, Baltar J, Sobrinho-Simoes M
- Issue date: 2001 Apr
- Cribriform-morular variant of papillary thyroid carcinoma: a pathological and molecular genetic study with evidence of frequent somatic mutations in exon 3 of the beta-catenin gene.
- Authors: Xu B, Yoshimoto K, Miyauchi A, Kuma S, Mizusawa N, Hirokawa M, Sano T
- Issue date: 2003 Jan
- Cribriform-morular variant of papillary carcinoma: a distinctive variant representing the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma?
- Authors: Cameselle-Teijeiro J, Chan JK
- Issue date: 1999 Apr
- Cribriform-morular variant of papillary carcinoma: the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma. A case report with clinical and molecular genetic correlation.
- Authors: Ng SB, Sittampalam K, Goh YH, Eu KW
- Issue date: 2003 Feb
- Cribriform-morular variant of papillary thyroid carcinoma: ultrastructural study and somatic/germline mutation analysis of the APC gene.
- Authors: Kameyama K, Mukai M, Takami H, Ito K
- Issue date: 2004 Mar-Apr
Showing items related by title, author, creator and subject.
Thyroid status affects number and localization of thyroid hormone receptor expressing mast cells in bone marrow.Siebler, T; Robson, Helen; Bromley, Michael; Stevens, D A; Shalet, Stephen M; Williams, Graham R; Department of Endocrinology, Christie Hospital NHS Trust, Manchester, UK. (2002-01)Thyroid hormone (T(3)) plays a key role in endochondral ossification. The process relies on the coordinated synthesis and degradation of cartilage matrix and is disrupted in juvenile hypothyroidism, leading to abnormal skeletal development. Mast cells synthesize and store matrix-degrading enzymes. We examined whether thyroid status influences skeletal mast cell distribution in growing rats to determine whether they might modulate the actions of T(3) in bone. Tibiae were collected for histological, histochemical, immunohistochemical, and immunofluorescence analysis. Mast cells were increased throughout the bone marrow in hypothyroid rats compared with euthyroid, thyrotoxic, and hypothyroid-thyroxine replaced animals. Large numbers were present in metaphyseal marrow adjacent to the growth plate in hypothyroid animals and cells were distributed evenly throughout the marrow. Very few mast cells were present in metaphyseal marrow in other groups, but their numbers increased with increasing distance from the growth plate. T(3) receptor alpha1 (TRalpha1) was expressed in the nucleus and cytoplasm of skeletal mast cells, whereas TRalpha2 and TRbeta1 were restricted to the cytoplasm. Localization of TRs was not affected by altered thyroid status. Thus, disrupted endochondral ossification in hypothyroidism may be mediated in part by skeletal mast cells, which express TR proteins and may function as T(3) target cells.
No adverse affect in clinical outcome using low pre-ablation diagnostic (131)I activity in differentiated thyroid cancer: refuting thyroid stunning effect.Yap, Beng K; Murby, Brian; Department of Clinical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, England, U K; (2014-04-24)Context Published studies of thyroid stunning due to pre-ablation (131)I scanning in the treatment of differentiated thyroid cancer (DTC) following thyroidectomy had shown inconsistent clinical impact. Objective To evaluate the clinical outcome in patients who were given a low diagnostic (131)I activity (1.1mCi or 40MBq) 6 days prior to radioiodine ablation (RAI). Design/setting Two cohorts of patients treated in a cancer referral center in 2004-2011. The eligibility criteria were 1) diagnosis of differentiated thyroid carcinoma (DTC); 2) total or near total thyroidectomy; 3) no distant metastasis; 4) received ≥82.4mCi (3050MBq) therapeutic (131)I activity. Patients/Interventions 305 consecutive patients treated in 2004-2008 (group A) had a diagnostic activity 1.1mCi of (131)I prior to RAI. The second cohort treated in 2009-2011(group B) consisted of 237 patients who did not undergo diagnostic (131)I scanning prior to RAI. Main outcome measures The tumor recurrence rate at 3 years and quantitative assessment using diagnostic radioiodine scans (DxWBS) and TSH-stimulated thyroglobulin (Tg) levels at 3-12 months post RAI. Results The 3-year recurrence free survival rate were 96.4% in both groups with 4.3% in group A and 3.4% in group B had tumor recurrence (p=0.91). The ablation success rates measured by DxWBS were 97.6% and 100% and by stimulated Tg were 85.3% and 85.8% in group A and B respectively (p=0.62). Conclusions The use of low diagnostic (131)I activity (1.1mCi) given 6 days prior to RAI was safe and convenient without adversely affecting the long term clinical outcome.
The structure of the human thyroid in relation to ageing and focal thyroiditis.Harris, Martin; Palmer, Michael K; Department of Histopathology, Withington Hospital, Manchester M20 (1980-02)Quantitative studies of non-nodular thyroid glands without focal thyroiditis obtained from consecutive autopsies on women aged over 20 yr showed a decrease in colloid content and an increase in stromal tissues with advancing age. When focal lymphocytic thyroiditis was present these changes were increased. This observation supports the theory that low-grade auto-immune processes can mimic or accelerate the ageing process but does not indicate that they initiate it.