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Rhee YY, Jung HK, Kim SH, Kim SH. Hyalinizing Trabecular Tumor of the Thyroid Gland, a Diagnostic Challenge in Fine-Needle Aspiration Cytology: Case Report. J Pathol Transl Med 2018; 52:252-256. [PMID: 29890568 PMCID: PMC6056358 DOI: 10.4132/jptm.2018.04.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/27/2018] [Indexed: 11/26/2022] Open
Abstract
Hyalinizing trabecular tumor (HTT) is a rare thyroid tumor with low to minimal malignant potential. HTT is often misinterpreted as other thyroid tumors, including papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC), on fine-needle aspiration (FNA) cytology, because of its overlapping cytologic features, such as nuclear grooves and intranulcear pseudoinclusions. Although cytopathologists cannot definitely conclude HTT by FNA cytology, suspicion of HTT is necessary to avoid misdiagnosing HTT as PTC or MTC and to avoid unnecessary aggressive treatment. Here, we report a case of HTT with novel cytologic features in CellPrep liquid based cytology that was diagnosed as suspicious for papillary carcinoma by FNA and finally diagnosed as HTT in the surgical specimen.
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Affiliation(s)
- Ye-Young Rhee
- Pathology Center, Seegene Medical Foundation, Seoul, Korea
| | - Hong Kyu Jung
- Department of Surgery and Health Care Center, Seran Hospital, Seoul, Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - Soo Hee Kim
- Pathology Center, Seegene Medical Foundation, Seoul, Korea
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Takada N, Hirokawa M, Ohbayashi C, Nishikawa T, Itoh T, Imagawa N, Oyama T, Handa T, Hasegawa T, Sugita S, Murata A, Miyauchi A. Re-evaluation of MIB-1 immunostaining for diagnosing hyalinizing trabecular tumour of the thyroid: semi-automated techniques with manual antigen retrieval are more accurate than fully automated techniques. Endocr J 2018; 65:239-244. [PMID: 29199205 DOI: 10.1507/endocrj.ej17-0413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hyalinizing trabecular tumour (HTT) immunohistochemically shows cell membranous immunoreactivity for MIB-1. This aberrant immunoreactivity is an important factor for the diagnosis of HTT. However, fully automated stainers frequently fail to confirm the immunoreactivity. The aim of this study is to investigate the cause of false negative cell membranous immunoreactivity for MIB-1 in HTT using fully automated stainers, to determine potential reasons for the problem, and to establish methods confirming cell membranous immunoreactivity for MIB-1 in HTT. Six participating institutions examined immunoreactivity for MIB-1 in 10 HTT cases using two approaches: fully automated and semi-automated methods. In the latter, antigen retrieval was carried out using manual methods adopted for routine assays at each institute. The autostainers used included the BOND-MAX, BOND-III, Benchmark XT, and Omnis systems. Using fully automated methods, institute E showed cell membranous MIB-1 positivity in all HTT cases. In contrast, at institute D, all HTT cases were negative. The positive rates of the remaining four institutes ranged from 10% to 20%. The incidence of positive cases using semi-automated methods was 100%, 90%, 90%, 30%, 80%, and 100% at institutes A, B, C, D, E, and F, respectively. We assert that antigen retrieval should be conducted manually for diagnosis of HTT; furthermore, definitively diagnosed HTT should be prepared as the external positive control.
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Affiliation(s)
- Nami Takada
- Department of Clinical Laboratory, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Takeshi Nishikawa
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Naoko Imagawa
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Tetsunari Oyama
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 370-8511, Japan
| | - Tadashi Handa
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 370-8511, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido 060-8543, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido 060-8543, Japan
| | - Akiko Murata
- Department of Technical Development, Genostaff Co. Ltd., Bunkyo-ku, Tokyo 113-0032, Japan
| | - Akira Miyauchi
- Department of Surgery, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
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Jones DJ, Kieliszak CR, Patel SS, Selinsky CR. Hyalinizing trabecular tumor of the thyroid gland and its significant diagnostic issue. Thyroid Res 2017; 10:7. [PMID: 29051791 PMCID: PMC5634960 DOI: 10.1186/s13044-017-0042-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyalinizing trabecular tumors (HTT) are rare follicular cell-derived tumors of the thyroid gland that are infrequently reported in otolaryngology literature. We present here an interesting case of HTT which provides the basis for review of this entity's clinical characteristics, criteria useful in making the diagnosis, and any currently available therapeutic modalities. CASE PRESENTATION A 70-year-old Caucasian female underwent a CT scan of her chest and was incidentally found to have a nodule within the right thyroid lobe. Gross examination of the excised thyroid lobe revealed a circumscribed and encapsulated lesion (tan / gritty in texture), confined to the gland. Histologic sections of the lesion revealed a circumscribed neoplasm with a trabecular and organoid architecture associated with abundant dystrophic calcification. Neoplastic cells showed a spindled morphology with clumped chromatin and ample eosinophilic cytoplasm. CONCLUSIONS Histologically, HTT is a follicular cell-derived tumor composed of neoplastic cells arranged in a trabecular pattern with hyalinization and calcification of extracellular material. Distinguishing features of HTT include minimal cytologic atypia with a low nuclear: cytoplasmic ratio, cellular aggregates around hyalinized material, and nuclei with clumped chromatin and occasional grooves and/or pseudoinclusions. Though debated in the literature, the general consensus is that this tumor is a benign entity. It is our hope that additional clinical research will elicit awareness of these rare tumors.
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Affiliation(s)
- Dustin J Jones
- Department of Otolaryngology, Head and Neck Surgery, The Detroit Medical Center, Detroit, MI USA
| | - Christopher R Kieliszak
- Department of Otolaryngology Head and Neck Surgery, OhioHealth Doctors Hospital, 5100 W Broad Street, Columbus, OH 43228 USA
| | - Sanjay S Patel
- Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, WI USA
| | - Christopher R Selinsky
- Department of Otolaryngology Head and Neck Surgery, OhioHealth Doctors Hospital, 5100 W Broad Street, Columbus, OH 43228 USA
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