title: The cytological, clinical, and pathological features of the cribriform-morular variant of papillary thyroid carcinoma and mutation analysis of CTNNB1 and BRAF genes.
abstract: BACKGROUND
  The cribriform-morular variant of papillary thyroid carcinoma (CMVPTC) is an unusual subtype of papillary thyroid carcinoma. The goal of this study was to determine the clinicopathological features of CMVPTC and whether the tumor can be diagnosed by fine-needle aspiration cytology.
  
  
  METHODS
  We retrospectively analyzed the clinical appearance and pathological findings in five patients with CMVPTC and sequenced exon 3 of CTNNB1 and exon 15 of BRAF in tumor tissue.
  
  
  RESULTS
  All patients were young women, 15-34 years of age at the time of the cancer diagnosis. Preoperative cytological examination showed scattered tall columnar cells, fascicular spindle cells, and cribriform and morular patterns in the fine-needle aspirates of the thyroid from the five patients. Grossly, all tumors were well-circumscribed, solid or cystic. Immunohistochemically, most tumor cells showed nuclear expression of thyroid transcription factor-1, estrogen and progesterone receptors, and p53; cytoplasmic expression of cytokeratins 7 and 19, vimentin, and bcl-2; and cytoplasmic and nuclear accumulation of beta-catenin and galectin-3. There was no expression of thyroglobulin, cytokeratin 5/6, or human mesothelial cell-1. However, among these markers, the morular cells showed only positive immunostaining for beta-catenin, galectin-3, p53, and bcl-2. A CTNNB1 mutation was identified in only one case and no BRAF mutation was found in any of the five cases.
  
  
  CONCLUSIONS
  Taken together, these data suggest that CMVPTC can be diagnosed preoperatively, based on careful cytology examination, and shows unique immunohistochemical findings.
authors.affiliation: Department of Hospital Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.forename: Yeong-Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Kyo-Young
authors.initials: KY
authors.lastname: Lee
authors.forename: Ja-Seong
authors.initials: JS
authors.lastname: Bae
authors.forename: Hyung-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Seung-Kew
authors.initials: SK
authors.lastname: Yoon
authors.forename: Young-Ik
authors.initials: YI
authors.lastname: Son
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
authors.forename: Young Lyun
authors.initials: YL
authors.lastname: Oh
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000235:genetics*; D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D010375:Pedigree; D048493:Proto-Oncogene Proteins B-raf / Q000096:biosynthesis / Q000235:genetics*; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000235:genetics*; D051176:beta Catenin / Q000096:biosynthesis / Q000235:genetics*
chemical_list: C495270:CTNNB1 protein, human; D051176:beta Catenin; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf