Clinical utility of the imunohistochemical co-expression of p53 and MDM2 in thyroid follicular lesions.

In order to investigate the possible correlation between p53 and MDM2 co-expression with clinicopathological features of differentiated thyroid cancer (DTC) and its use as diagnostic and/or prognostic markers, we used immunohistochemistry to evaluate 317 thyroid samples including 208 DTC and 94 benign nodules, in addition to 15 normal tissues. MDM2 and p53 expression were highly associated (r = 0.7161; p < 0.0001). The co-expression of p53-MDM2 was observed more frequently in malignant lesions (p < 0.0001) and helped characterize follicular patterned lesions distinguishing FVPTC from FA (p < 0.0001) and FVPTC from FTC (p < 0.0001). In addition, p53-MDM2 co-expression was associated with characteristics of less aggressiveness. It was more frequent in patients ≤45 years old (p = 0.0035), with unique tumors (p = 0.0095), tumors <2 cm (p < 0.0001), tumors without extrathyroid invasion (p = 0.0425), without metastasis at evolution (p = 0.0179), and in patients evolving free of disease after treatment (p = 0.0485). We suggest that p53-MDM2 co-expression profile analysis might help establishing diagnostic and determining prognostic of DTC patients.

Direct preparation protocol to obtain mitotic chromosomes from canine mammary tumors.

Currently, mammary neoplasms in female canines are a serious problem in veterinary clinics. In addition, the canine species is an excellent disease model for human oncology because of the biological and genetic similarities between the species. Cytogenetics has allowed further study of the characterization of neoplasms in canines. We hypothesized that the use of a direct preparation protocol for mitotic chromosome analysis would provide a simple and low cost protocol for use in all laboratories. The objective of this method is to display in a few hours of dividing cells just like the time of collection since cell division in tissue can be obtained. Ten female canines with the spontaneous occurrence of mammary neoplasia were used to test a pioneering direct preparation protocol to obtain mitotic chromosomes. The excised breast tumor tissue fragments were subjected to the protocol consisting of treatment with colchicine, treatment with hypotonic solution, and fixation. Mitotic chromosomes were absent in cell suspensions of only two samples among the 10 materials analyzed, based on the analysis of five blades for each preparation obtained. So, the cell suspension obtained allowed for the observation of eight tissue samples viable for cytogenetic analysis, five of which had excellent numbers of mitotic chromosomes. However, the technique was unsuccessful in producing high-quality cell suspensions because of inadequate condensation and scattering of chromosomes. While adjustments to methodological procedures are needed, this protocol represents a low cost and simplified method to study the cytogenetics of canine tumors.

Papillary carcinoma in a thyroglossal duct: case report

CONTEXT: Thyroglossal duct cysts are the most common congenital cervical abnormality in childhood. Malignant lesions are rare in thyroglossal duct cysts (about 1 percent). OBJECTIVE: To report a case of papillary carcinoma in thyroglossal duct cysts. DESIGN: Case report. CASE REPORT: The patient was a 21-year-old female with a four-month history of an anterior midline neck mass but without other symptoms. The physical examination revealed a 4.0 cm diameter, smooth, painless, cystic nodule at the level of the hyoid bone. The thyroid gland was normal by palpation and no neck lymph nodes were found. Indirect laryngoscopy, fine-needle biopsy aspiration and cervical ultrasound were normal and compatible with the physical findings of a thyroglossal duct cyst. The patient underwent surgery with this diagnosis, under general anesthesia, and the mass was resected by the usual Sistrunk procedure. There were no local signs of invasion of the tissue surrounding the cyst or duct at surgery. The patient was discharged within 24 hours. Histopathological examination of the specimen showed a 3.5 x 3.0 x 3.0 cm thyroglossal cyst, partially filled by a solid 1.0 x 0.5 cm brownish tissue. Histological sections showed a papillary carcinoma in the thyroid tissue of a thyroglossal cyst, with normal thyroid tissue at the boundary of the carcinoma. There was no capsule invasion and the margins were negative. The follow-up of the patient consisted of head and neck examinations, ultrasonography of the surgical region and thyroid, and total body scintigraphy. The patient has been followed up for two years with no further evidence of disease

Thyroid papillary carcinoma arising in a branchial cleft cyst.

We describe the clinico-pathological features and discuss the possible pathogenetic mechanism of thyroid papillary carcinoma arising in a branchial cleft cyst. This has been described only once previously in the literature.

Cytopathology of the tall cell variant of thyroid papillary carcinoma.

The tall cell variant of thyroid papillary carcinoma differs from classic papillary carcinoma in its more aggressive clinical behavior, cell type (columnar amphophilic to oxyphilic) and higher frequency of stromal lymphoid infiltrate. A retrospective study of three such cases was made, with an emphasis given to the utility of fine needle aspiration cytology in their identification. Aspirates revealed papillary fronds and cyanophilic and oxyphilic neoplastic cells with a high proportion of nuclear grooves and cytoplasmic inclusions. These nuclear details allowed a specific diagnosis of papillary carcinoma with oxyphil cells as compared to oxyphilic cell follicular tumors. Smears from two cases showed, in addition, lymphoid cells and multinucleate giant cells. In them a diagnosis of coexisting Hashimoto's disease, granulomatous thyroiditis or inflammatory tumor stroma could not be excluded cytologically.

Cytologic findings in the follicular variant of papillary carcinoma of the thyroid.

Fine needle aspirates from 8 thyroid papillary carcinomas, follicular variant, were studied. Histologically the tumors were composed exclusively of follicles (four cases) or an admixture of follicular and trabecular structures (four cases). Follicles were identified in smears from seven cases (87.5%) and sheets reminiscent of a trabecular pattern in one (12.5%). Colloid material presented as intraluminal (one case) or extraluminal, dense, round masses (six cases). Nuclear cytoplasmic inclusions occurred in seven (87.5%) of the cases. All these features have been described for follicular lesions or neoplasia together with occasional nuclear grooves, as occurred in two (25%) of the studied cases. In the other six (75%) cases, a moderate to high proportion of neoplastic cells with nuclear grooves facilitated the diagnosis of papillary carcinoma. Our findings suggest that a careful microscopic search for nuclear grooves should be attempted in aspirates yielding a diagnosis of follicular neoplasia that could otherwise be indistinguishable from the follicular variant of papillary carcinoma of the thyroid.

Carcinoma papilífero da tireóide: revisäo anatomopatológica / Papillory carcinoma of the thyroid: revision

O A. faz consideraçöes gerais a propósito da história natural do câncer da tireóide, em particular sobre questöes epidemiológicas e prognósticas. Por fim, discute os aspectos histopatológicos mais salientes sobre as variantes morfológicas do carcinoma papilífero