Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India.
Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India.
Int J Surg Pathol. 2024 Aug;32(5):1009-1016. doi: 10.1177/10668969231206572. Epub 2023 Oct 25.
Cribriform morular thyroid carcinoma has been added under tumors of uncertain histogenesis. Its peculiar clinical, histomorphological pattern, and immunohistochemical profile have been proved different from papillary thyroid carcinoma. A 59-year-old female patient had a lesion in the left lobe of the thyroid. Fine needle aspiration cytology was reported as medullary thyroid carcinoma. The total thyroidectomy specimen showed a predominantly solid tumor of size 9.5 cm in the left lobe. Microscopy showed a mixed growth pattern with the dominant cribriform and solid morular area. Nuclear features of papillary carcinoma were not seen. Squamoid morules had nuclear clearing. Marked stromal hyalinization and calcification were noted. Extrathyroidal extension, lymphovascular invasion, and lymph node metastasis were not identified. Immunohistochemically the tumor cells were diffuse and strong nuclear positive for β-catenin, TTF1, PAX8, estrogen receptor, focal, and weak positivity for CD5. Synaptophysin, calcitonin, thyroglobulin, and CDX2 were negative. We report this rare cribriform morular thyroid carcinoma case with its associated uncommon histological and immunohistochemical features.
筛状滤泡状甲状腺癌已被归入组织来源不明的肿瘤。其独特的临床、组织形态学模式和免疫组织化学特征已被证明与甲状腺乳头状癌不同。一位 59 岁的女性患者左叶甲状腺有一处病变。细针穿刺细胞学检查报告为髓样甲状腺癌。全甲状腺切除术标本显示左叶有一个 9.5 厘米大小的主要实性肿瘤。显微镜下显示出一种混合生长模式，以筛状和实性滤泡状为主。未见乳头状癌的核特征。有核空泡化的鳞状滤泡。明显的间质玻璃样变性和钙化。未发现甲状腺外侵犯、血管淋巴管侵犯和淋巴结转移。免疫组织化学显示肿瘤细胞弥漫性强阳性表达β-连环蛋白、TTF1、PAX8、雌激素受体，局灶性和弱阳性表达 CD5。突触素、降钙素、甲状腺球蛋白和 CDX2 均为阴性。我们报告了这例罕见的筛状滤泡状甲状腺癌病例，并伴有其相关的不常见的组织学和免疫组织化学特征。
