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PubMedDate not supplied

[Computer morphometry in the differential diagnosis of thyroid neoplasms].

The quantitative studies of follicular thyroid tumors were applied for their morphological differentiation. The computer-aided analysis of the images permits objective and prompt estimation of the quantitative parameters of the structural components of a tumor in the histological sections. The comparison of the values obtained in the tissue samples could identify the most typical differentially diagnostic criteria that could help to define the type of a tumor, by replacing a routine morphological study based on the analysis of qualitative morphological signs. Its effectiveness is largely determined by the skill of a physician and the subjectivity of assessments of observed phenomena.

Adenoma↗
PubMed2005

Galectin-3 immunodetection in follicular thyroid neoplasms: a prospective study on fine-needle aspiration samples.

Fine-needle aspiration cytology, which is well established to be accurate for the diagnosis of thyroid cancer, may be inconclusive for the follicular thyroid neoplasms. As galectin-3 was suggested to be a marker of malignant thyrocytes, we investigated whether this protein might be helpful in the diagnosis of aspirates classified as undeterminate by cytology. After establishing an easy processing of aspirates for galectin-3 immunodetection, a series of aspirates categorised as benign (n=63), malignant (n=17) or undeterminate (n=34) was prospectively analysed for galectin-3. Only the patients with malignant or undeterminate lesions underwent surgery. Most lesions (86%) diagnosed as malignant by cytology or after surgery were positive for galectin-3. The majority of lesions (94%) classified as benign by cytology or after surgery was negative for galectin-3. The positive and negative predictive values were 83 and 95%, respectively. When focusing on the undeterminate lesions, the sensitivity and specificity were 75 and 90%, respectively, while the positive and negative predictive values were 82 and 87%, respectively. The specificity and the positive predictive value were higher (100%) when considering the percentage of stained cells. Altogether these results show that galectin-3 constitutes a useful marker in the diagnosis of thyroid lesions classified as undeterminate by conventional cytology.

Adenocarcinoma, Follicular↗
PubMed2006

Cyclooxygenase-2 and inducible nitric oxide synthase expression in thyroid neoplasms and their clinicopathological correlation.

To evaluate the expressions of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) in thyroid neoplasms in a Korean population, we studied a total of 154 cases: papillary carcinoma of classical type (PTC), 86; follicular adenoma (FA), 21; follicular carcinoma (FC), 35; medullary carcinoma (MC), 3; undifferentiated carcinoma (UC), 5; and Hurthle cell neoplasm (HN), 4. Using immunohistochemical staining, COX-2 expression was detected in 62 (72.1%) PTC specimens, 5 (23.8%) FA specimens, 10 (28.6%) FC specimens, 0 (0.0%) MC specimens, 1 (20.0%) UC specimen, and 3 (75%) HN specimens. iNOS expression was detected in 66 (76.7%) PTC specimens, 4 (19.0%) FA specimens, 13 (37.1%) FC specimens, 0 (0.0%) MC specimens, 3 (60.0%) UC specimens, and 4 (100%) HN specimens. The results showed that COX-2 and iNOS were frequently expressed in the PTC and HN specimens, and iNOS was more frequently overexpressed in the FC specimens than in the FA specimens. In PTC, COX-2 and iNOS were significantly overexpressed in patients over 45 yr of age (p=0.029, p=0.041), and iNOS expression was increased in patients with a large primary tumor (p=0.028). These results suggest that the upregulation of COX-2 and iNOS may contribute to the tumor progression of thyroid gland, particularly in PTC and HN, and iNOS may play an adjuvant role during the tumor progression of FC.

Adult↗
PubMed2003

p130 expression in thyroid neoplasms: its linkage with tumor size and dedifferentiation.

p130 belongs to the retinoblastoma-related gene family, and its gene product works to negatively regulate cell cycle progression in the G1 phase. In this study, we investigated p130 expression in thyroid neoplasms. p130 overexpression was observed in 33.3% of follicular adenoma and 50% of follicular carcinoma and the incidences were not significantly different. In papillary carcinoma, it was overexpressed in 36.5% of cases, but in microcarcinoma, the incidence was significantly lower (14.3%). Furthermore, in anapalstic carcinoma, p130 overexpression was less frequently seen than in papillary carcinoma except for microcarcinoma and follicular carcinoma, and only 14.3% of cases overexpressed this protein. These findings suggest that: (1) reduced p130 expression may contribute to the aggressive character of anplastic carcinoma; and (2) p130 may specify the growth characteristics of microcarcinoma.

Carcinoma↗
PubMedDate not supplied

New attempt of preoperative differential diagnosis of thyroid neoplasms by telomerase activity measurement.

Telomerase activity (TA) has been shown highly expressed in various solid malignant neoplasms, but only rarely in benign tumor or normal tissues. Most reports examined TA by the qualitative method, telomeric repeat amplification protocol (TRAP) assay. We examined TA in tissues of thyroid neoplasm by quantitative method to establish whether TA was a useful marker for preoperative differential diagnosis of thyroid tumors. TA was measured by the quantitative method, TRAP assay, fluorescence based TRAP method in 32 frozen tissues of thyroid tumors (17 malignant, 15 benign). Cut-off values in TA were 0 unit and 9 units from mean +/- 2SD of TA in benign thyroid tumors. Mean (SD) TA levels in benign thyroid tumors and thyroid carcinomas were 2.06 (3.58) units and 30.5 (38.2), respectively. Mean TA of carcinomas was significantly higher than that of benign disease in thyroid tumors (p=0.0092). The sensitivity of the malignancy was 64.7% (cut-off <0) (p=0.162), 52.9% (cut-off <9) (p=0.0048). TA in thyroid carcinoma was significantly correlated with UICC stage (p=0.029), and slightly correlated with tumor size, pN and M. Positive rate of TA in microfollicular adenoma was slightly higher than that in macrofollicular adenoma. Conclusively, quantitative TA might be a useful marker for differential diagnosis between benign and malignant thyroid tumors.

Adenocarcinoma, Follicular↗
PubMed2000

Epithelial membrane antigen and S-100 protein expression in benign and malignant papillary thyroid neoplasms.

Papillary carcinoma of the thyroid is mainly diagnosed with histopathologic features. Classical papillary architectures are important but nuclear change is the essential diagnostic element. Papillary architecture may be seen in benign lesions such as in hyperplastic areas of the follicular neoplasms, multinodular goiter and Grave's disease. Differential diagnosis of papillary carcinoma and papillary hyperplasia is very important for clinical management. Some authors have reported that Epithelial Membrane Antigen (EMA) and S-100 protein expression would be valuable and helpful in identifying papillary neoplasia and distinguishing it from papillary hyperplasia. In this study, EMA and S-100 protein expression of 14 papillary thyroid carcinomas and 13 papillary hyperplasias were studied by using immunohistochemical methods. In 14 papillary carcinomas, 9 showed diffuse and 3 revealed focal S-100 protein nuclear and cytoplasmic immunostaining. Two cases were not stained. All of the 13 papillary hyperplasias were negative for S-100 protein. EMA expression was observed in the apical cytoplasmic location of 11 papillary carcinomas except one case that showed diffuse cytoplasmic staining and one which was negative. In the papillary hyperplasias, 7 revealed both cytoplasmic and apical cytoplasmic staining. One case showed only cytoplasmic staining. Five cases were negative for EMA. The difference in the S-100 protein expression is significant, however immunostaining of EMA is similar in both lesions. We concluded that differential diagnosis of papillary structures in carcinomas and hyperplasias was mainly diagnosed on the histopathologic features but S-100 protein expression could be helpful in difficult cases.

Carcinoma, Papillary↗
PubMed1992

Pheochromocytomas and C-cell thyroid neoplasms in transgenic c-mos mice: a model for the human multiple endocrine neoplasia type 2 syndrome.

Transgenic mice carrying and expressing a mos protooncogene, linked to the Moloney murine sarcoma virus long terminal repeat, develop severe neurological defects and lens abnormalities. Here we report that after long latent periods, mice in three of four of these mos transgenic lines develop a high frequency of multicentric pheochromocytomas and/or medullary thyroid neoplasms. The pattern of tumor formation is remarkably similar to the human autosomal dominantly inherited neoplastic syndrome, multiple endocrine neoplasia type 2 (MEN 2), and tumors from these transgenic animals display the same neuroendocrine marker staining pattern as seen in MEN 2. The similarity between the tumor pathologies and presentation patterns of MEN 2 patients and mos transgenic mice suggests that they may arise through related pathways. The type of tumor presentation varies in a line-dependent manner indicating that there is interaction between the transgene and the genetic background. Moreover, when the non-tumor-bearing mos transgenic line is crossed to a different mouse background, the F1 offspring display the MEN 2 phenotype. These studies indicate that penetrance of the autosomal dominant mos transgenic phenotype is dependent on both integration site and background.

Adrenal Gland Neoplasms↗
PubMed1993

Fine needle aspiration cytology combined with argyrophilic nucleolar organizer regions (AgNORs) in diagnosis of thyroid neoplasms.

NORs are the loops of DNA that contain the sites of ribosomal genes around which the nucleolus is formed during telophase of mitosis. In light microscopy they can be visualized by simple silver staining technique as small dark dots within the nucleus. It has been recognized that in many neoplasms, especially malignant AgNORs are more numerous and often atypical when compared with benign tumors and normal tissue. We have introduced this novel technique to the fine needle cytology of thyroid neoplasms (n = 56). We have analyzed the number, the area of AgNORs, the number of clustered AgNORs in the nucleus and the ratio of AgNOR area to the nuclear area and the area of single AgNOR by means of semiautomatic computerized image analysis. We have studied cytological samples consisting of 7 simple goiters, 7 hyperplasias, 15 follicular adenomas, 7 oxyphilic follicular adenomas, 6 follicular carcinomas, 8 oxyphilic follicular carcinomas, 6 papillary adenocarcinomas. In this study we have demonstrated that some differences in the AgNORs value are associated with the type of tumor rather than with malignancy. Location of the AgNORs seems to be very typical for some types of tumors. For example in oxyphilic neoplasms they form single clusters in the nucleus and in papillary adenocarcinomas they form at least two abundant clusters. In other proliferative lesions of the thyroid gland location of AgNORs is less typical.

Adenoma↗
PubMedDate not supplied

Metastatic breast carcinoma mimicking primary thyroid neoplasm in young women.

OBJECTIVE: To highlight awareness of the potential for breast carcinoma to manifest as a thyroid lesion. METHODS: We present two case reports of young women with thyroid nodules and discuss diagnostic techniques and treatment strategies. RESULTS: In two women, 32 and 38 years old, neither of whom had a history of carcinoma, thyroid nodules were suspected clinically of being primary thyroid neoplasms. In each case, histopathologic evaluation disclosed that the tumors appeared "foreign" to the thyroid and resembled infiltrating duct carcinomas of the breast. In some histologically confusing cases, immunostaining for thyroglobulin and calcitonin may prove diagnostically helpful. The usual treatment for lesions metastatic to the thyroid is surgical resection. CONCLUSION: Metastatic breast carcinomas may manifest as primary thyroid lesions, especially in women younger than age 40 years.

Journal Article↗
PubMed1980

Benign and malignant thyroid neoplasms after childhood irradiation for tinea capitis.

The incidence of all thyroid surgery was studied among 10,842 persons whose thyroid glands had been exposed in childhood to an average dose of 9 rads of X-radiation during treatment for tinea capitis and among 2 matched control groups. A statistically significant increased risk for both benign and malignant neoplasms was found in the exposed group. The excess risk was 8.3 cases/year/rad/million population. There were no differences in other surgical conditions between the irradiated and nonirradiated groups. Persons irradiated under age 6 years had the highest excess risk for developing carcinomas. The incidence of thyroid neoplasms was approximately threefold higher in women than in men among the irradiated persons and among the controls, but the relative risk for the irradiated group of women was greater than the addition of the relative risks of the other groups. Low-dose radiation is instrumental in the development of both benign and malignant thyroid neoplasms.

Adenoma↗
PubMed2000

Galectin-3 expression in various thyroid neoplasms and its possible role in metastasis formation.

Galectin-3 is a member of the beta-galactoside-binding protein family that plays an important role in cell-cell adhesion and in cell-matrix interaction. We have examined the expression of galectin-3 in normal, adenomatous, and malignant thyroid tissues and also in metastatic lesions. Galectin-3 was rarely expressed in normal thyroid tissue but was abundant in the cytoplasm of the neoplastic lesions. Among neoplastic lesions, galectin-3 was expressed to a greater extent in follicular carcinomas than in follicular adenomas and was present in greater amounts in papillary carcinomas than in follicular adenomas or carcinomas. Primary lesions of papillary carcinoma with metastasis contained significantly higher concentrations of galectin-3 than tumors of this type without metastases. However, the expression of galectin-3 was significantly decreased in metastatic lesions in the lymph nodes compared with their primary lesions. From these results, we assumed that galectin-3 works in different ways at different stages of thyroid neoplasm proliferation. Among primary tumors, galectin-3 expression is significantly different in 3 histological types. However, the continuity of progression among these tumors is not yet proven. In later stages, decreased expression of galectin-3 may aid the release of cancer cells from the primary lesions for invasion and metastasis.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Telomerase activity in thyroid neoplasms evaluated by the expression of human telomerase reverse transcriptase (hTERT).

BACKGROUND: The recent availability of a monoclonal antibody against human telomerase reverse transcriptase (hTERT) has enabled us to investigate the telomerase activity of tissue specimens more easily than by classical TRAP assay. In this study, we studied teromerase activity in thyroid tumors using this antibody. MATERIALS AND METHODS: We immunohistochemically investigated hTERT expression in 166 thyroid neoplasms. RESULTS: Normal follicular cells did not express hTERT. In papillary carcinoma, high hTERT expression was observed in 34.5% of cases and it was directly linked to stage and the presence of lymph node metastasis. In follicular carcinoma, 39.2% were classified as the high hTERT expression group, showing a significantly higher incidence than that in follicular adenoma, 9.8%. In anaplastic carcinoma, 73.7% were regarded as the high hTERT expression group, which was larger than the percentages in papillary and follicular carcinomas. We investigated the diagnostic usefulness of hTERT measurement for discriminating follicular carcinoma from adenoma. Its specificity and positive predictive value were high at 90.2% and 83.3%, respectively, while the sensitivity and negative predictive value were low. CONCLUSION: These results suggest that: i) telomerase activity contributes to anaplastic transformation of differentiated carcinoma and ii) hTERT measurement may contribute to diagnosing follicular carcinoma, but whether it can be applied to preoperative diagnosis by fine-needle aspiration biopsy specimens remains unclear.

Adenocarcinoma, Follicular↗
PubMed1995

[Thyroid neoplasms in children and adolescents--personal experience].

Between 1974-1992 we operated 12,344 patients at the Clinic of Surgery of the Institute of Endocrinology of the Lódź Medical Academy for various forms of goiter. Of these, 295 patients were between the ages of 9-18 years, including 268 (90.8%) girls and 27 (9.2%) boys. Malignant thyroid neoplasm was diagnosed in 19 of these children (6.4%). From among the 268 girls, malignant tumors were discovered in 15 (5.6%), while among the 27 boys, in 4 (14.8%). Ten of these neoplasms were carcinoma papillare, 9 carcinoma folliculare. All of the children are alive without signs of metastases or recurrence. None developed hypoparathyroidism, but one child presented unilateral paresis of the vocal chords.

Adolescent↗
PubMed1986

The role of fine-needle aspiration biopsy in the rapid diagnosis and management of thyroid neoplasm.

This report describes our 5-year experience with fine-needle aspiration (FNA) biopsy of the thyroid in a 560-bed teaching hospital. Three hundred nine FNA biopsies were performed primarily by one endocrinologist and interpreted by several pathologists. Analysis of the data reveals the sensitivity of the procedure is 93%, specificity is 95.1%, and the positive and negative predictive values are 88.9% and 96.5%, respectively. This data confirms the diagnostic accuracy of FNA biopsy. Complications were seen in 6 of 309 cases (1.9%) and were relatively mild. Nearly 75% of the cases in the series were cytologically diagnosed as nonneoplastic. Fine-needle aspiration biopsy identified 19.4% of the cases needing surgery, of which 72% had neoplastic nodules, confirming the selection role of the procedure. The management of thyroid nodules is discussed and a selective review of the FNA literature is presented. The authors believe that our experience rebuts the argument that special referral centers are needed to interpret the cytologic material. Several well trained surgical pathologists can become proficient in interpreting the FNA biopsies without significant loss in accuracy, and thereby render a definite diagnosis in the vast majority of the cases. Accordingly, the authors recommend FNA of the thyroid as the initial diagnostic test in the evaluation of thyroid nodules.

Adenocarcinoma↗
PubMed2001

Beta-catenin dysregulation in thyroid neoplasms: down-regulation, aberrant nuclear expression, and CTNNB1 exon 3 mutations are markers for aggressive tumor phenotypes and poor prognosis.

beta-catenin has a role in cell adhesion and Wnt signaling. It is mutated or otherwise dysregulated in a variety of human cancers. In this study we assess beta-catenin alteration in 145 thyroid tumors samples from 127 patients. beta-catenin was localized using immunofluorescence and mutational analysis was performed by single-strand conformational polymorphism. Membrane beta-catenin expression was decreased in eight of 12 (66%) adenomas and in all 115 carcinomas (P: < 0.0001). Among carcinomas, reduced membrane beta-catenin was associated with progressive loss of tumor differentiation (P: < 0.0001). CTNNB1 exon 3 mutations and nuclear beta-catenin localization were restricted to poorly differentiated [7 of 28 (25%) and 6 of 28 cases (21.4%), respectively] or undifferentiated carcinomas [19 of 29 (65.5%) and 14 of 29 (48.3%) cases, respectively]. Poorly differentiated tumors always featured mutations involving Ser and Thr residues and were characterized by Thr to Ile amino acid substitutions (P: = 0.0283). The association between CTNNB1 exon 3 mutations and aberrant nuclear immunoreactivity (P: = 0.0020) is consistent with Wnt activation because of stabilizing beta-catenin mutations. Low membrane beta-catenin expression as well as its nuclear localization or CTNNB1 exon 3 mutations are significantly associated with poor prognosis, independent of conventional prognostic indicators for thyroid cancer but not of tumor differentiation. Analysis of beta-catenin dysregulation may be useful to objectively subtype thyroid neoplasms and more accurately predict outcomes.

Adenoma↗