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A Calcitonin-Negative Neuroendocrine Tumor Derived from Follicular Lesions of the Thyroid.

Kim GY, Park CY, Cho CH, Park JS, Jung ED, Jeon EJ - Endocrinol Metab (Seoul) (2014)

Bottom Line: Initially, USG-guided aspiration cytology was performed, and a MTC was suspected.The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology.However, the staining of calcitonin, a marker of MTCs, was not observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

ABSTRACT
Neuroendocrine lesions of the thyroid are rare. The most common types are medullary thyroid carcinomas (MTCs) and C-cell hyperplasia. MTCs originate from thyroid parafollicular cells that secrete calcitonin which serves as a serum marker of MTCs. Here, the rare case of a calcitonin-negative neuroendocrine tumor (NET) derived from follicular lesions of the thyroid is described. A 34-year-old man presented at our hospital for the surgical management of an incidental thyroid nodule that was observed on an ultrasound sonography (USG) of the neck. Initially, USG-guided aspiration cytology was performed, and a MTC was suspected. The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology. However, the staining of calcitonin, a marker of MTCs, was not observed. A nonmedullary NET of the thyroid is uncommon, and the distinction between calcitonin-negative NETs and MTCs of the thyroid may be important due to differences in their clinical courses and management.

No MeSH data available.


Related in: MedlinePlus

Histologic findings showing a well-differentiated neuroendocrine tumor (A, H&E stain, ×100) with calcitonin-negative immunohistochemical staining (B, ×200) of tumor cells.
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Figure 2: Histologic findings showing a well-differentiated neuroendocrine tumor (A, H&E stain, ×100) with calcitonin-negative immunohistochemical staining (B, ×200) of tumor cells.

Mentions: The patient underwent a right lobectomy in March 2012. The specimen measured approximately 0.6×0.5 cm, and the histological findings revealed a poorly differentiated carcinoma with a solid and trabecular pattern; these features are consistent with those of a NET (Fig. 2). There was no vascular invasion or metastasis of the tumor cells into regional lymph nodes. Immunohistochemical analyses were performed on the resected tumor (Fig. 3) and showed that the tumor cells were immunopositive for thyroglobulin and thyroid transcription factor-1 (TTF-1), which are thyroid follicular cell markers, and for synaptophysin and chromogranin A, which are neuroendocrine markers. There were no indications of calcitonin or CEA immunoreactivities in the tumor cells (Table 1). The patient did not exhibit any clinical evidence of tumor recurrence during the 1 year follow-up period.


A Calcitonin-Negative Neuroendocrine Tumor Derived from Follicular Lesions of the Thyroid.

Kim GY, Park CY, Cho CH, Park JS, Jung ED, Jeon EJ - Endocrinol Metab (Seoul) (2014)

Histologic findings showing a well-differentiated neuroendocrine tumor (A, H&E stain, ×100) with calcitonin-negative immunohistochemical staining (B, ×200) of tumor cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508268&req=5

Figure 2: Histologic findings showing a well-differentiated neuroendocrine tumor (A, H&E stain, ×100) with calcitonin-negative immunohistochemical staining (B, ×200) of tumor cells.
Mentions: The patient underwent a right lobectomy in March 2012. The specimen measured approximately 0.6×0.5 cm, and the histological findings revealed a poorly differentiated carcinoma with a solid and trabecular pattern; these features are consistent with those of a NET (Fig. 2). There was no vascular invasion or metastasis of the tumor cells into regional lymph nodes. Immunohistochemical analyses were performed on the resected tumor (Fig. 3) and showed that the tumor cells were immunopositive for thyroglobulin and thyroid transcription factor-1 (TTF-1), which are thyroid follicular cell markers, and for synaptophysin and chromogranin A, which are neuroendocrine markers. There were no indications of calcitonin or CEA immunoreactivities in the tumor cells (Table 1). The patient did not exhibit any clinical evidence of tumor recurrence during the 1 year follow-up period.

Bottom Line: Initially, USG-guided aspiration cytology was performed, and a MTC was suspected.The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology.However, the staining of calcitonin, a marker of MTCs, was not observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

ABSTRACT
Neuroendocrine lesions of the thyroid are rare. The most common types are medullary thyroid carcinomas (MTCs) and C-cell hyperplasia. MTCs originate from thyroid parafollicular cells that secrete calcitonin which serves as a serum marker of MTCs. Here, the rare case of a calcitonin-negative neuroendocrine tumor (NET) derived from follicular lesions of the thyroid is described. A 34-year-old man presented at our hospital for the surgical management of an incidental thyroid nodule that was observed on an ultrasound sonography (USG) of the neck. Initially, USG-guided aspiration cytology was performed, and a MTC was suspected. The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology. However, the staining of calcitonin, a marker of MTCs, was not observed. A nonmedullary NET of the thyroid is uncommon, and the distinction between calcitonin-negative NETs and MTCs of the thyroid may be important due to differences in their clinical courses and management.

No MeSH data available.


Related in: MedlinePlus