Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.
Department of Oncology-Pathology, Cancer Centre Karolinska (CCK) R8:04, Karolinska Institutet, 17176, Stockholm, Sweden.
Endocr Pathol. 2018 Dec;29(4):365-368. doi: 10.1007/s12022-018-9539-2.
The ultimobranchial body (UBB) denotes the cellular mass originating from the fourth branchial pouch, which migrates from the neural crest and infolds within the middle and upper poles of the thyroid lobes, thereby establishing the presence of calcitonin-secreting parafollicular C cells. In various numbers, UBB remnants (entitled "solid cell nests", or SCNs) are found in thyroid glands examined histologically. However, despite the close embryological relation between the UBB and the superior parathyroid glands, intraparathyroidal SCNs have to our knowledge not been previously reported. Here, we describe a patient presenting with a papillary thyroid carcinoma with central and lateral lymph node metastases. Upon postoperative analysis, an unintentionally removed parathyroid gland was observed adjacent to the superior aspect of the right thyroid lobe. Within a 0.6 × 0.5-mm area of the parathyroid gland, solid nests composed of epithelial cells with oval and slightly elongated nuclei were seen. The cells were positive for p40, p63, and GATA3, but negative for PTH. The final diagnosis was a SCN entrapped within the parathyroid gland. Empirically, we have not previously observed SCNs within the parathyroid glands. To our knowledge, our finding thus constitutes a very unusual histological manifestation, and could indicate an underlying aberrancy during embryogenesis given the close anatomical relationship between the UBB and the superior parathyroid glands.
甲状旁腺内的 UBB 残余(称为“实性细胞巢”或 SCN)
后鳃体(UBB)表示源自第四鳃囊的细胞团,它从神经嵴迁移并在内脏中折叠在甲状腺叶的中上极,从而建立降钙素分泌的滤泡旁 C 细胞。在组织学检查的甲状腺中,以各种数量发现 UBB 残余(称为“实性细胞巢”或 SCN)。然而,尽管 UBB 和甲状旁腺之间具有密切的胚胎学关系,但据我们所知,甲状旁腺内的 SCN 尚未被报道。在这里,我们描述了一位患有甲状腺乳头状癌伴中央和侧颈部淋巴结转移的患者。术后分析时,观察到无意中切除的甲状旁腺紧邻右甲状腺叶的上侧。在甲状旁腺的 0.6×0.5mm 区域内,可见由具有椭圆形和略微拉长核的上皮细胞组成的实性巢。这些细胞对 p40、p63 和 GATA3 呈阳性,但对 PTH 呈阴性。最终诊断为 SCN 困在甲状旁腺内。根据经验,我们以前没有在甲状旁腺内观察到 SCN。据我们所知,我们的发现因此构成了一种非常不寻常的组织学表现,并可能表明在胚胎发生期间存在潜在的异常,因为 UBB 和甲状旁腺之间具有紧密的解剖关系。