title: Occult oncocytic papillary thyroid carcinoma with lymphoid stroma (Warthin-like tumor): report of a case with concomitant mutations of BRAF V600E and V600K.
abstract: Warthin-Like tumor of the thyroid is a recently described rare variant of papillary thyroid cancer. The distinct histological feature of this variant is papillary architecture lining oncocytic epithelial cells with nuclear characteristics of papillary carcinoma, accompanied by prominent lymphocytic infiltration in the papillary stalks. Here, we present a case of occult Warthin-like papillary thyroid carcinoma, 0.5-cm in maximum dimension, underwent left thyroid lobectomy in a 65 years old Chinese woman. In this case, there was no extrathyroid extension, vascular invasion and lymphatic metastasis, as well as no complication of lymphocytic thyroiditis. Immunohistochemistry staining revealed that the tumor cells were positive for Leu-M1, HBME-1, 34βE12, and MIB-1 labeling index was low. RET/PTC expression was absent in tumor cells. Furthermore, activated point mutations of BRAF V600E and V600K were concurrently detected by DNA sequencing. Further studies are needed to elucidate the prevalence and role of BRAF(V600K) mutation in papillary thyroid carcinoma, and long-term follow-up for the patient is needed to clarify the biological behavior of this variant with dual BRAF mutations.
authors.affiliation: Department of Pathology, Shanghai Tongji Hospital Affiliated to Shanghai Tongji University 389 Xincun Rd, Shanghai 200065, China ; Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University 241 West Huaihai Rd, Shanghai 200030, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Han
authors.affiliation: Department of Pathology, Shanghai Tongji Hospital Affiliated to Shanghai Tongji University 389 Xincun Rd, Shanghai 200065, China.
authors.forename: Long
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Shanghai Tongji Hospital Affiliated to Shanghai Tongji University 389 Xincun Rd, Shanghai 200065, China.
authors.forename: Suxia
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Shanghai Nanxiang Hospital 495 Zhonghe Rd, Jiading District, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Shanghai Tongji Hospital Affiliated to Shanghai Tongji University 389 Xincun Rd, Shanghai 200065, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Yi
mesh_terms: D000235:Adenolymphoma / Q000201:enzymology / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D018249:Adenoma, Oxyphilic / Q000201:enzymology / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000368:Aged; D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics*; D001706:Biopsy; D002291:Carcinoma, Papillary / Q000201:enzymology / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008969:Molecular Sequence Data; D017354:Point Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D013964:Thyroid Neoplasms / Q000201:enzymology / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: BRAF mutation; Warthin-like; papillary thyroid carcinoma