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Hurthle cell carcinoma and papillary carcinoma

Debasis Gochhait, Praveena Edura, Rajesh Nachiappa Ganesh, Neelaiah Siddaraju, Vidhyalakshmi Rangarajan, Thara Keloth
Poorly differentiated thyroid carcinoma (PDTC) is an uncommon neoplasm of thyroid accounting for 4-7% of all thyroid neoplasm's (1) that are rarely diagnosed accurately on cytology. Medullary thyroid carcinoma (MTC) is the most frequent primary thyroid neoplasm manifesting with plasmacytoid morphology possibly followed by Hürthle neoplasm (HCN) because of their high incidence compared to other subtypes of malignancy. The plasmacytoid morphology in other primary thyroid neoplasms is uncommon and distinguishing such neoplasm's from MTC is crucial for the clinical management of patients presenting with neoplastic thyroid nodules...
February 3, 2019: Cytopathology: Official Journal of the British Society for Clinical Cytology
Bin Xu, Ed Reznik, R Michael Tuttle, Jeffrey Knauf, James A Fagin, Nora Katabi, Snjezana Dogan, Nathaniel Aleynick, Venkatraman Seshan, Sumit Middha, Danny Enepekides, Gian Piero Casadei, Erica Solaroli, Giovanni Tallini, Ronald Ghossein, Ian Ganly
PURPOSE: In 2016, non-invasive encapsulated follicular variant of papillary thyroid carcinoma (NI-EFVPTC) was renamed as noninvasive thyroid follicular neoplasm with papillary-like nuclear features (NIFTP). However, as the study cohort did not mention tumors with oncocytic features, such lesions are still labeled by some as FVPTC. It is therefore crucial to evaluate the outcome and molecular profile of oncocytic NI-EFVPTC. METHODS: A multi-institutional clinico-pathologic review was conducted to select 61 patients having oncocytic NI-EFVPTC...
January 28, 2019: Endocrine
Karin van der Tuin, Marina Ventayol, Willem Corver, Midia Khalifa, Dina Ruano, E P Corssmit, Frederik J Hes, Thera P Links, Jan Smit, Theo S Plantinga, E Kapiteijn, Ton Van Wezel, Hans Morreau
OBJECTIVE: Gene alterations leading to activation of the MAPK pathway are of interest for targeted therapy in patients with advanced radioactive iodine-refractory (RAI-R) thyroid carcinoma. Due to technical reasons gene fusion analysis in RNA isolated from formalin-fixed tumor tissues has till now been limited. The objective of the present study was to identify targetable gene rearrangements in RNA isolated from formalin-fixed RAI-R thyroid carcinomas. DESIGN: Retrospective study in 132 patients with RAI-R thyroid carcinoma (59 papillary-, 24 follicular-, 35 Hürthle cell-, and 14 anaplastic thyroid carcinoma)...
January 1, 2019: European Journal of Endocrinology
Robert I Haddad, Christian Nasr, Lindsay Bischoff, Naifa Lamki Busaidy, David Byrd, Glenda Callender, Paxton Dickson, Quan-Yang Duh, Hormoz Ehya, Whitney Goldner, Megan Haymart, Carl Hoh, Jason P Hunt, Andrei Iagaru, Fouad Kandeel, Peter Kopp, Dominick M Lamonica, Bryan McIver, Christopher D Raeburn, John A Ridge, Matthew D Ringel, Randall P Scheri, Jatin P Shah, Rebecca Sippel, Robert C Smallridge, Cord Sturgeon, Thomas N Wang, Lori J Wirth, Richard J Wong, Alyse Johnson-Chilla, Karin G Hoffmann, Lisa A Gurski
The NCCN Guidelines for Thyroid Carcinoma provide recommendations for the management of different types of thyroid carcinoma, including papillary, follicular, Hürthle cell, medullary, and anaplastic carcinomas. These NCCN Guidelines Insights summarize the panel discussion behind recent updates to the guidelines, including the expanding role of molecular testing for differentiated thyroid carcinoma, implications of the new pathologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features, and the addition of a new targeted therapy option for BRAF V600E-mutated anaplastic thyroid carcinoma...
December 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Biserka Pigac, Silvija Masic, Zdenka Hutinec, Valentina Masic
Introduction: Hürthle cell adenoma is a rare benign lesion of the thyroid gland, however, controversies about its potential malignant behavior still remain. Among thyroid neoplasms, papillary carcinoma is the most common variant with great variety of histological subtypes demonstrating different biological behavior. Aim: To raise the awareness of possible coexistence of these two lesions and discussion about possible therapeutic approaches. Case report: A 42 year old female patient was examined because of the pain in the thyroid area...
November 2018: Medical Archives
C Christofer Juhlin, Robert Bränström, Ivan Shabo, Anders Höög
Follicular neoplasms of the thyroid gland are most often characterized by follicular-patterned thyrocytes with a neutrally stained cytoplasm, while a minority of cases present with oncocytic differentiation (Hürthle cell tumors). Exceedingly rare variants with a clear cell phenotype have also been reported, both as clear cell follicular thyroid adenomas (ccFTAs) and clear cell follicular carcinomas (ccFTCs). We present a patient with a 30-mm lesion in the thyroid isthmus in which the preoperative cytology proposed a follicular tumor...
October 29, 2018: International Journal of Surgical Pathology
Khalid S Aljabri, Samia A Bokhari, Muneera A Al, Patan Murthuza Khan
BACKGROUND: Thyroid carcinoma (TC) is the ninth most common site of all cancers in women in the world and the second most common malignancy in Saudi Arabia. This reports updates data on the epidemiology of the disease in Saudi Arabia. OBJECTIVE: Describe and interpret changes in the frequency of TC to compare with other populations and determine proportions of certain histological types of TC. DESIGN: Medical record review. SETTING: Military hospital in Jeddah, Saudi Arabia...
September 2018: Annals of Saudi Medicine
Tyler Janovitz, Justine A Barletta
Although differentiated thyroid carcinomas typically pursue an indolent clinical course, it is important to identify the subset of tumors that are most likely to behave aggressively so that patients with these tumors are counseled and treated appropriately. Extent of disease is fundamental to the prognostication for differentiated thyroid carcinoma; however, there are additional histologic features of the tumor separate from extent of disease that have been shown to affect clinical course. This review will start with a discussion of aggressive variants of papillary thyroid carcinoma, move to the prognostic significance of vascular invasion in follicular thyroid carcinoma, and finish with a discussion of Hürthle cell carcinoma, with an emphasis on why it is not considered a subtype of follicular thyroid carcinoma in the 2017 WHO Classification of Tumors of Endocrine Organs...
December 2018: Endocrine Pathology
Ilana Slutzky-Shraga, Yulia Sternov, Eyal Robenshtock, Gloria Tzvetov, Carlos Benbassat, Dania Hirsch
OBJECTIVE: The accurate diagnosis of thyroid follicular/Hürthle cell tumors is challenging and a matter of controversy. We present a series of patients in whom a misclassification of follicular/Hürthle cell thyroid lesions as benign has led to devastating clinical outcomes. METHODS: The Thyroid Cancer Registry of Rabin Medical Center was screened for patients with metastatic differentiated thyroid carcinoma (DTC) who had been initially diagnosed with benign follicular lesion between 1974 and 2015 and treated with hemithyroidectomy...
August 2018: Endocrine Practice
Dilip K Das
Synthesis and storage of thyroglobulin as well as synthesis of thyroid hormones and their release into the circulation are important functions of thyroid, which were studied in fine needle aspiration (FNA) smears from thyroid lesions. Evidence of thyroglobulin synthesis was demonstrated in neoplastic and nonneoplastic follicular cells, especially in Hürthle cells, in the form of colloid inclusions. Whereas the pinocytic vesicles containing colloid at the luminal end of in nonneoplastic and neoplastic follicular cells indicated engulfment of colloid for synthesis of thyroid hormones (T3 and T4 ), the marginal vacuoles (MVs) (fire-flare appearance) at the basal aspects of follicular cells suggested their release on way to the interfollicular capillaries...
July 2018: Journal of Cytology
Gustavo C Penna, Ana Pestana, José Manuel Cameselle, Denise Momesso, Fernanda Accioly de Andrade, Ana Paula Aguiar Vidal, Mario Lucio Araujo Junior, Miguel Melo, Priscila Valverde Fernandes, Rossana Corbo, Mario Vaisman, Manuel Sobrinho-Simões, Paula Soares, Fernanda Vaisman
PURPOSE: Evaluate the impact of TERTp mutation on the outcomes after initial treatment of 45 patients with thyroid carcinomas derived from follicular cells (TCDFC) with aggressive histology, in which the role of this mutation is not yet well defined. METHODS: Analysis of the presence of TERTp (-124C > T and -146C > T), BRAF (V600E), and NRAS (Q 61R) mutations by Sanger sequencing and analysis of their correlation with the patient's outcomes. RESULTS: Forty-five patients with aggressive histopathologic variants were included in the study...
September 2018: Endocrine
Małgorzata Wójcik, Anna Ruszała, Ewa Szczudlik, Dominika Janus, Krystyna Sztefko
BACKGROUND: The clinical value of the diagnosis of metabolic syndrome (MS) in children and adolescents remains unclear. The aim of the present study was to assess the occurrence of metabolic complications, other than included in 2007 IDF MS definition, in obese children and adolescents METHODS: The study included 75 (33 boys) obese adolescents (mean age 13.9 years, mean BMI SDS 4.49). Classical (fasting glucose, TGL, HDL, blood pressure) and non classical (insulin resistance [HOMA-IR], creatinine, AST, ALT, uric acid, fibrinogen, liver US and 24h BP profile) risk factors were compared between groups with and without MS...
May 6, 2018: Neuro Endocrinology Letters
Chan Kwon Jung, Yourha Kim, Sora Jeon, Kwanhoon Jo, Sohee Lee, Ja Seong Bae
Follicular-patterned tumors of the thyroid gland are characterized by a predominantly follicular growth pattern. They frequently harbor RAS mutations, not BRAF mutations. Technological advances in molecular testing have discovered novel RAS-type mutations. However, clinical significance of these mutations remains unknown. We investigated the prevalence and clinical impact of mutations of BRAF, NRAS, HRAS, KRAS, EZH1, EIF1AX, and TERT genes by Sanger sequencing in a series of 201 follicular-patterned thyroid tumors including follicular adenoma (n=40), Hürthle cell adenoma (n=54), noninvasive follicular thyroid neoplasms with papillary-like nuclear features (n=50), follicular thyroid carcinoma (n=40), Hürthle cell carcinoma (n=10), and poorly differentiated thyroid carcinoma arising in a well differentiated follicular neoplasm (n=7), and 120 classic papillary carcinoma...
April 30, 2018: Human Pathology
Arash Ordookhani, Abbas Motazedi, Kenneth D Burman
Background: The number of studies on venous thromboembolism (VTE) and thyroid cancer is very scarce and existing data are contradictory. This paper reviews VTE in thyroid cancer. Methods: The following words were used for a comprehensive literature review using MEDLINE database: Blood coagulation factors; thyroid hormones; blood coagulation tests; venous thromboembolism; receptors thyroid hormone; hemostasis; fibrinolysis; bleeding; blood coagulation disorders; thyroid neoplasms; Thyroid cancer, papillary; Thyroid cancer, follicular; Thyroid carcinoma, anaplastic; Thyroid cancer, Hurthle cell; Familial medullary thyroid carcinoma; venous thrombosis; Pulmonary embolism; Blood coagulation factors...
January 2018: International Journal of Endocrinology and Metabolism
Hui Chen, Rajyalakshmi Luthra, Mark J Routbort, Keyur P Patel, Maria E Cabanillas, Russell R Broaddus, Michelle D Williams
Next-generation sequencing (NGS) for molecular diagnostics allows simultaneous testing of activating oncogenes and tumor suppressor mutations in multiple signal pathways. Extended mutational profiling of advanced thyroid cancers may enhance considerations for targeted therapies. We analyzed clinically derived molecular profiling of 216 patients with advanced thyroid carcinoma using NGS (Ion Torrent Personal Genome Machine) from April 2012 to February 2014. We examined substitutions and small indels in 46 or 50 cancer-related genes using Ampliseq Cancer Hotspot panel in respect to tumor diagnosis and clinical correlations...
July 2018: Molecular Cancer Therapeutics
Ceren Canbey Goret, Nuri Emrah Goret, Omer Faruk Ozkan, Muammer Karaayvaz
A 22-year-old patient underwent fine needle aspiration of a nodule at the outer center of the right lobe of the thyroid, and it was reported to be Bethesda system category IV, Hurthle cell follicular neoplasia. The patient, who persented to Onsekiz Mart University Research and Application Hospital, underwent surgery. During right total thyroidectomy, an almost totally infarcted nodule and papillary structures around these infarcted areas were detected. Herein, we report on diagnostic challenges faced in confirming whether the infarcted nodule was a case of reactive papillary changes or an underdiagnosed papillary carcinoma and how the challenges were overcome using immunohistochemistry analysis and molecular genetic testing...
2018: Northern Clinics of Istanbul
Amber L Smith, Michelle D Williams, John Stewart, Wei-Lien Wang, Savitri Krishnamurthy, Maria E Cabanillas, Sinchita Roy-Chowdhuri
BACKGROUND: The identification of BRAF mutations in thyroid cancer has prognostic and therapeutic implications. Although the gold standard for identifying BRAF mutations is molecular testing, the ability to perform BRAF p.V600E immunostaining on fine-needle aspiration (FNA) samples can facilitate the rapid triaging of patients to treatment options. METHODS: A total of 50 thyroid carcinoma FNA samples, including papillary (29 samples), poorly differentiated (10 samples), anaplastic (9 samples), and Hurthle cell (2 samples) carcinomas, with a known BRAF p...
June 2018: Cancer Cytopathology
Rui Dou, Lili Zhang, Tingxia Lu, Dong Liu, Fang Mei, Jian Huang, Linxue Qian
HRas proto-oncogene ( HRAS ) is one of the most commonly mutated genes in thyroid cancer, with mutations frequently occurring in the follicular and Hurthle cell subtypes. However, the contribution of mutations in HRAS to papillary thyroid carcinoma (PTC) progression and the tall-cell variant (TCV) is poorly understood. The aim of the present study was to investigate the somatic genetic variants present in HRAS in patients with PTC, and to investigate the association of these mutations with PTC. The present study is a retrospective case-control study using tumor samples collected from 139 patients with PTC and blood samples from 195 healthy individuals...
April 2018: Oncology Letters
Jisup Kim, Beom Jin Lim, Soon Won Hong, Ju Yeon Pyo
BACKGROUND: Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA) specimens is challenging especially with lymphocytic thyroiditis characterized by Hürthle cells and lymphocytic background. To determine a helpful cytological differential point, we compared WLV-PTC FNA findings with conventional papillary thyroid carcinoma with lymphocytic thyroiditis (PTC-LT) and conventional papillary thyroid carcinoma without lymphocytic thyroiditis (PTC) regarding infiltrating inflammatory cells and their distribution...
March 2018: Journal of Pathology and Translational Medicine
Jen-Fan Hang, William H Westra, Amy G Zhou, David S Cooper, Syed Z Ali
BACKGROUND: The recent revision in terminology, with noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) replacing noninvasive follicular variant of papillary thyroid carcinoma, has reclassified the clinically indolent tumor as nonmalignant. The objective of this study was to evaluate the impact of this change on the rate of malignancy (ROM) for subcategories of an atypia of undetermined significance (AUS) diagnosis on fine-needle aspiration (FNA) cytology...
May 2018: Cancer Cytopathology
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