Do black (dark) lymph-node metastases in papillary thyroid carcinoma suggest more advanced or aggressive disease?
BACKGROUND
In some patients, papillary thyroid carcinoma (PTC) lymph-node metastases are noted to be black (dark) in color at the time of surgical removal. The goal of this project was to determine histological, genetic, and clinical features that are associated with regional black PTC metastasis.


METHODS
Fifteen patients with black PTC metastases (black-PTC) were compared to a control cohort of 15 patients with nonblack PTC metastasis (nonblack PTC). Each sample was evaluated for the histological characteristics, BRAF V600E mutational status, and associated patient clinical data.


RESULTS
The degree of cystic degeneration (80% vs. 27%, p=0.004), percent hemosiderin deposition (20% vs. 6%, p=0.001), and presence of classical variant (100% vs. 67%, p=0.018) were significantly greater in black PTC than nonblack PTC (α=0.05). Other results were not significantly different.


CONCLUSIONS
This study demonstrates that black compared to nonblack metastases have a greater degree of cystic degeneration and hemosiderin deposition leading to discoloration, and a trend toward an increased incidence in BRAF V600E mutations. This study is the first of its kind to describe the clinical, pathological, and genetic features associated with black PTC lymph-node metastasis.
Department of Pathology, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.
Henry S
HS
Crist
Juanita J
JJ
Evans
Haresh
H
Mani
Brian
B
Saunders
Jeffrey
J
Fornadley
Fabian
F
Camacho
David
D
Goldenberg
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000235:genetics / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000556:secondary; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology*
D048493:Proto-Oncogene Proteins B-raf