Follicular thyroid carcinoma with an unusual glomeruloid pattern of growth.
We describe an uncommon thyroid tumor in a 56-year-old woman. The widely infiltrating, angioinvasive neoplasm, 5 cm in diameter, exhibited a peculiar architectural growth pattern characterized by follicles with round to oval epithelial tufts growing within, often supported by a fibrovascular core mimicking the renal glomerulus. Colloid-empty follicles, tubular or elongated, were lined by pseudostratified tall, columnar cells with clear cytoplasm. Nuclei were round to oval, with evenly distributed, slightly coarse chromatin. Tumor cells were positive for thyroid transcription factor-1, thyroperoxidase, thyroglobulin, cytokeratin 18, Hector Battifora mesothelial cell, and vimentin. Scattered cells positive for S100, Wilms tumor 1 (WT1), and cytokeratins AE1/AE3 were found, with no reaction detected for cytokeratins 34betaE12, 5/6, 7, 19, or 20. There were PAX8-PPARgamma rearrangement and N-RAS mutation. No mutations were found for APC or BRAF genes, nor were RET/PTC rearrangements detected. Because of the distinctive histologic features, we propose naming this tumor follicular thyroid carcinoma with an unusual glomeruloid pattern of growth.
Cameselle-Teijeiro
José
J
Department of Pathology, Clinical University Hospital, SERGAS, University of Santiago de Compostela, 15706 Santiago de Compostela, Galicia, Spain. apjocame@usc.es
Pardal
Fernando
F
Eloy
Catarina
C
Ruiz-Ponte
Clara
C
Celestino
Ricardo
R
Castro
Patricia
P
Soares
Paula
P
Sobrinho-Simões
Manuel
M
D018263:Adenocarcinoma, Follicular / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D014408:Biomarkers, Tumor / Q000378:metabolism; D002467:Cell Nucleus / Q000473:pathology; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D015321:Gene Rearrangement; D011905:Genes, ras / Q000235:genetics; D006801:Humans; D007453:Iodide Peroxidase / Q000378:metabolism; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D053538:Keratin-18 / Q000378:metabolism; D008875:Middle Aged; D009154:Mutation; D009361:Neoplasm Invasiveness; D009687:Nuclear Proteins / Q000235:genetics / Q000378:metabolism; D000072636:PAX8 Transcription Factor; D047495:PPAR gamma / Q000235:genetics / Q000378:metabolism; D051761:Paired Box Transcription Factors / Q000235:genetics / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D000074482:Thyroid Nuclear Factor 1; D013965:Thyroidectomy; D014157:Transcription Factors / Q000235:genetics / Q000378:metabolism; D014746:Vimentin / Q000378:metabolism; D000951:Antigens, Neoplasm
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D007453:Iodide Peroxidase; D007457:Iodine Radioisotopes; D053538:Keratin-18; D009687:Nuclear Proteins; D000072636:PAX8 Transcription Factor; D047495:PPAR gamma; D051761:Paired Box Transcription Factors; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors; D014746:Vimentin; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm; C000614412:NKX2-1 protein, human; C083325:PAX8 protein, human