Solid Thyroid Follicular Nodules With Longitudinal Nuclear Grooves
| Autor: | David Suster, A. Craig Mackinnon, Vania Nosé, Saul Suster |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Thyroid nodules Pathology medicine.medical_specialty Adenoma Malignancy Pathology and Forensic Medicine Thyroid carcinoma Cytokeratin Adenocarcinoma Follicular Follicular phase Biomarkers Tumor medicine Humans Thyroid Neoplasms Thyroid Nodule Aged Aged 80 and over business.industry Thyroid General Medicine Middle Aged medicine.disease Immunohistochemistry Carcinoma Papillary Medical Laboratory Technology medicine.anatomical_structure Female business |
| Zdroj: | Archives of Pathology & Laboratory Medicine. 146:984-993 |
| ISSN: | 1543-2165 0003-9985 |
| Popis: | Context.— Follicular thyroid nodules can be a source of diagnostic difficulties, particularly when they display atypical features commonly associated with malignancy, such as nuclear grooves. Objective.— To differentiate lesions with atypical features from similar-appearing benign and malignant lesions. Design.— Eighteen cases of atypical follicular thyroid nodules characterized by a solid growth pattern and prominent longitudinal nuclear grooves were studied and examined for clinicopathologic characteristics. Results.— The lesions occurred in 16 women and 2 men aged 36 to 88 years and measured from 0.2 to 1.5 cm. The tumors were well circumscribed and noninvasive, and histologically characterized by a predominantly solid growth pattern with rare scattered follicles or a combination of solid growth pattern with minor follicular areas. A striking feature seen in all cases was the occurrence of longitudinal nuclear grooves. Immunohistochemical stains showed negativity for cytokeratin 19 (CK19) and HBME-1 in 8 cases; in the other 10, there was focal positivity for HBME-1 in 4 cases and diffuse positivity in 6. All cases were negative for galectin-3 and for CK19, with the exception of 1 case, which was CK19+/HBME-1−. Next-generation sequencing of 16 cases with a 161-gene panel detected 14 single nucleotide variants in 12 cases, predominantly NRAS and HRAS mutations. Clinical follow-up ranging from 18 to 72 months (median, 43.7 months) did not disclose any evidence of recurrence or metastases. Conclusions.— We interpret these lesions as low-grade, indolent follicular proliferations that need to be distinguished from papillary thyroid carcinoma, follicular adenoma, and noninvasive follicular thyroid neoplasms with papillary-like nuclear features. |
| Databáze: | OpenAIRE |
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