Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 131, Issue 1, Pages 134-142Publisher
OXFORD UNIV PRESS INC
DOI: 10.1309/AJCP7ULS0VSISBEB
Keywords
APC; Cribriform-morular variant; Familial adenomatous polyposis; Neuroendocrine differentiation; Papillary carcinoma; RET-PTC; p53; beta-Catenin; Thyroid cancer; CD10
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Funding
- Charles III Health Institute (Ministry of Health and Consumer Affairs), Madrid, Spain [P1060209]
- Portuguese Science and Technology Foundation [POCI/SAU-OBS/56175/2004]
- Fundação para a Ciência e a Tecnologia [POCI/SAU-OBS/56175/2004] Funding Source: FCT
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We describe an especially aggressive case of cribriform-morular variant (C-MV) of papillary thyroid carcinoma (PTC) in a 42-year-old man with familial adenomatous polyposis who died with lung and brain metastases 17 months after thyroidectomy. The angioinvasive neoplasm combined a mixture Of trabecular, solid, cribriform, and follicular patterns of growth with CD10+ morules. Follicles were devoid of colloid, and the nuclear features typical of PTC were present in some areas and missing in others. Tumor cells were positive for thyroid transcription factor-1 and, in 40% of the tumoral mass, also were positive for chromogranin and synaptophysin and were negative for thyroglobulin and calcitonin. Strong nuclear staining for beta-catenin was found in all tumor cells, as was positivity for p53 and cyclin D1. In addition to the germline heterozygous APC Ex 2-3 duplication mutation, a somatic homozygous silent p. Thr1493Thr gene variant was found in the neoplastic cells along with RET/PTC rearrangement. This tumor represents the first case of C-MV of PTC showing neuroendocrine differentiation.
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