title: [Clinicopathologic characteristics of head and neck carcinoma showing thymus-like element].
abstract: Objective:To investigate clinicopathological features of carcinoma showing thymus-like elements (CASTLE) in the head and neck regions.Methods:Clinicopathological data of 7 patients with CASTLE in the head and neck regions were retrospectively reviewed.Immunohistochemical staining and in situ hybridization for EBER were performed. BRAF(V600E) mutation was examined by ARMS method in 6 cases.Results:There were 5 females and 2 males with age between 49 and 78 years (average of 65.6 years). All tumors were solitary nodular lesions with an infiltrative border, including 6 intrathyroid tumors and 1 extrathyroid tumor in the laryngeal pharynx.The tumors were 1.7-4.1 cm in diameter (average of 3.0 cm). Four cases demonstrated lymph node metastasis.All patients were alive without metastasis during follow-up, except one consultation case (with FNA sample) developed recurrence at the primary site. The cases showed different immunoreaction to CD5, diffuse immunoreaction with p63, CK5/6 and CD117, but negative staining for TTF1, TG and calcitonin. One case showed positive immunoreaction with Synin less than 30% tumor cells. The Ki-67 labeling index was between 3% and 90%. No BRAF(V600E) mutation and EB virus infection were detected.Conclusions:Extrathyroid CASTLE involving laryngeal pharynx shows the similar morphological and immunohistochemical features with intrathyroid CASTLE.Immunohistochemical markers of CD5 and CD117 are helpful in the diagnosis. Ki-67 labeling index can be high in CASTLE, especially in lymphoepithelioma type. CD5-negative CASTLE may have neuroendocrine differentiation. BRAF(V600E) mutation and EB virus may not be involved in the carcinogenesis of CASTLE.
authors.affiliation: Department of Pathology, Shandong University Qilu Hospital, Jinan 250012, China.
authors.forename: X J
authors.initials: XJ
authors.lastname: Cui
authors.forename: C Y
authors.initials: CY
authors.lastname: Zhang
authors.forename: P
authors.initials: P
authors.lastname: Su
authors.forename: B
authors.initials: B
authors.lastname: Lyu
authors.forename: Y B
authors.initials: YB
authors.lastname: Ren
authors.forename: X S
authors.initials: XS
authors.lastname: Fan
authors.forename: X F
authors.initials: XF
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: Y H
authors.initials: YH
authors.lastname: Song
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Liu
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000378:metabolism / Q000473:pathology*; D048493:Proto-Oncogene Proteins B-raf / Q000378:metabolism; D012189:Retrospective Studies; D013950:Thymus Gland / Q000473:pathology; D013953:Thymus Neoplasms / Q000378:metabolism / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D048493:Proto-Oncogene Proteins B-raf
keywords: Head and neck neoplasms; Immunohistochemistry; Thyroid neoplasms