Detection of ectopic thyroid remnants: A serious diagnostic dilemma. When molecular biology and immunohistochemistry can solve the problem

详细信息    查看全文

• 作者：Esther Diana Rossi ; ^{esther.rossi@rm.unicatt.it} ; Maurizio Martini ; Patrizia Straccia ; Luigi Maria Larocca ; Guido Fadda
• 关键词：Tall cell papillary thyroid carcinoma ; Ectopic thyroid tissue ; Immunohistochemistry ; Molecular biology
• 刊名：Pathology - Research and Practice
• 出版年：2013
• 出版时间：15 January, 2013
• 年：2013
• 卷：209
• 期：1
• 页码：59-61
• 全文大小：705 K

文摘

The presence of ectopic thyroid tissue is a frequent diagnostic feedback related to a possible histogenetic abnormality or a result of post-surgical seeding. The important challenge is the diagnostic definition of its nature, which could lead to a different therapeutic approach. We describe a case with all the possible implications and differential diagnoses supported by the application of immunohistochemistry and BRAF-V600E molecular detection.

A 36-year-old girl with a left thyroid nodule underwent surgery with a diagnosis of angio-invasive tall cell variant of papillary carcinoma without lymph-node metastases. The patient history revealed a previous right lobectomy in another institution ten years before. The right neck dissection was histologically characterized by the presence of thymic residual and evidence of microfollicular microfoci (less than 1 mm) of thyroid tissue. Thyroid tumor cells were positive for thyroglobulin, TTF-1, HBME-1 and Galectin-3, while the residual ectopic thyroid tissue showed positivity only for TTF-1 and thyroglobulin. The molecular tests on the thyroid nodule revealed the presence of BRAF-V600E mutation, but wild type BRAF in the ectopic tissue. The histo-morphological definition of these remnants plays the most important role, but the application of immunohistochemistry and molecular biology may help to reach a conclusive diagnosis.