Journal of Pathology and Translational Medicine

Original Article

Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia: Hee Young Na, Miyoko Higuchi, Shinya Satoh, Kaori Kameyama, Chan Kwon Jung, Su-Jin Shin, Shipra Agarwal, Jen-Fan Hang, Yun Zhu, Zhiyan Liu, Andrey Bychkov, Kennichi Kakudo, So Yeon Park; J Pathol Transl Med. 2024;58(6):331-340. Published online November 7, 2024; DOI: https://doi.org/10.4132/jptm.2024.10.12

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Abstract PDF Supplementary Material: Background
This study was designed to compare diagnostic categories of thyroid fine needle aspiration cytology (FNAC) and incidence of thyroid tumors in the multi-institutional Asian series with a special focus on diagnostic category IV (suspicious for a follicular neoplasm) and follicular thyroid carcinomas (FTCs). Methods: Distribution of FNAC categories, incidence of thyroid tumors in resection specimens and cytologic diagnoses of surgically confirmed follicular adenomas (FAs) and FTCs were collected from 10 institutes from five Asian countries and were compared among countries and between FAs and FTCs. Results: The frequency of category IV diagnoses (3.0%) in preoperative FNAC were significantly lower compared to those in Western countries (10.1%). When comparing diagnostic categories among Asian countries, category IV was more frequent in Japan (4.6%) and India (7.9%) than in Taiwan (1.4%), Korea (1.4%), and China (3.6%). Similarly, incidence of FAs and FTCs in surgical resection specimens was significantly higher in Japan (10.9%) and India (10.1%) than in Taiwan (5.5%), Korea (3.0%), and China (2.5%). FTCs were more commonly diagnosed as category IV in Japan (77.5%) than in Korea (33.3%) and China (35.0%). Nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were more common in FTCs compared with FAs. Conclusions: Our study highlighted the difference in FNAC diagnostic categories of FTCs among Asian countries, which is likely related to different reporting systems and thyroid cancer incidence. Cytologic features such as nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were found to be useful in diagnosing FTCs more effectively.

Case Study

Follicular Proliferative Lesion Arising in Struma Ovarii: Min Jee Park, Min A Kim, Mi Kyung Shin, Hye Sook Min; J Pathol Transl Med. 2015;49(3):262-266. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.26

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Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibit-ed solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.

Citations

Citations to this article as recorded by

Role of gene sequencing in classifying struma ovarii: BRAF p.G469A mutation and TERT promoter alterations favour malignant struma ovarii
Sophie Neyrand, Alexis Trecourt, Jonathan Lopez, Pierre Alexandre Just, Françoise Descotes, Françoise Borson‐Chazot, Isabelle Ray‐Coquard, Myriam Decaussin‐Petrucci, Mojgan Devouassoux‐Shisheboran
Histopathology.2024; 84(2): 291. CrossRef
Malignant struma ovarii: next-generation sequencing of six cases revealed Nras, Braf, and Jak3 mutations
Roberta Poli, Maria Scatolini, Enrico Grosso, Francesca Maletta, Marco Gallo, Daniele Liscia, Anna Nelva, Flora Cesario, Giuseppe Forte, Jasna Metovic, Marco Volante, Emanuela Arvat, Mauro Papotti
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Proliferative struma ovarii: A rare case report
Shankhanila Mazumdar, GaganKumar Rangari, Neeraj Dhameja, NishaRani Agrawal
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Malignant struma ovarii presenting with follicular carcinoma: A case report with molecular analysis
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Gynecologic Oncology Reports.2019; 30: 100498. CrossRef
A Rare Case: Struma Ovarii in a 14-Year-Old Girl
Elif Iltar, Isin Ureyen, Tayfun Toptas, Melike Savas, Sema Çekiç, Aysel Uysal
Journal of Adolescent and Young Adult Oncology.2018; 7(1): 134. CrossRef
Proliferative Highly Differentiated Follicular Carcinoma Of Ovarian Origin (Hdfco) Presenting Long After Bilateral Oophorectomy
Natalie M. Liu, Neda Moatamed, Racquel S. Bueno, Wendy L. Sacks
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Original Articles

The Diagnostic Usefulness of HMGA2, Survivin, CEACAM6, and SFN/14-3-3 δ in Follicular Thyroid Carcinoma: Min Hye Jang, Kyeong Cheon Jung, Hye Sook Min; J Pathol Transl Med. 2015;49(2):112-117. Published online March 12, 2015; DOI: https://doi.org/10.4132/jptm.2015.01.31

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Abstract PDF

Background
Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy and its differential diagnosis includes follicular adenoma (FA) and adenomatous goiter (AG). Several ancillary markers have been suggested to aid in the diagnosis of FTC, but the successful use of these methods still needs to be validated. Methods: In the present study, we verified the immunoexpression of HMGA2, CEACAM6, survivin, and SFN/14-3-3 δ in lesions including 41 AGs, 72 FAs, and 79 FTCs. We evaluated their diagnostic usefulness, combined with galectin 3, Hector Battifora mesothelial 1 (HBME1), cytokeratin 19, and cyclin D1, in diagnosing FTC. Results: The expressions of HBME1 (65.8%) and HMGA2 (55.7%) were significantly higher in FTCs than in FAs and AGs (p<.001 and p=.005, respectively). HBME1 was the only marker that was more frequently expressed in FTCs than in FAs (p=.021) and it was more frequently expressed in follicular neoplasms than in AGs (p<.001). Among the novel markers, the combination of HMGA2 and HBME1 showed the highest sensitivity (72.2%) and specificity (76.1%) for diagnosing FTC. CEACAM6, survivin, and SFN/14-3-3 δ were barely expressed in most cases. Conclusions: Our present results show that only HMGA2 can be beneficial in differentiating FTC using the novel markers.

Citations

Citations to this article as recorded by

HMGA2 promotes nasopharyngeal carcinoma progression and is associated with tumor resistance and poor prognosis
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miR‐98‐5p promotes apoptosis and inhibits migration and cell growth in papillary thyroid carcinoma through Bax/Caspase‐3 by HMGA2
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Diagnostic performance of HMGA2 gene expression for differentiation of malignant thyroid nodules: A systematic review and meta‐analysis
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Expressions of Id-1 and Id-2 in Hyperplastic Thyroid Tissue and Thyroid Carcinoma.: Young A Kim, Young Joo Park, Do Joon Park, Seong Hoe Park, Ji Eun Kim; Korean J Pathol. 2006;40(1):60-65.

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Abstract PDF: BACKGROUND
Id proteins are a family of helix-loop-helix proteins and are regarded to be negative regulators of cell differentiation. In general, Id-1 and Id-2 expressions are upregulated during tumor development and progression in a variety of neoplasms, and these expressions may be associated with aggressive tumor behavior. However, little is known about the roles of Id-1 and Id-2 in thyroid neoplasms.
METHODS
The expressions of Id-1 and Id-2 were assessed immunohistochemically in 310 normal, hyperplastic, and neoplastic thyroid tissues using tissue microarrays.
RESULTS
Normal thyroid tissues rarely expressed Id-1 or Id-2. Moreover, whilst Id-1 expression was more elevated in malignant thyroid tissue than in hyperplastic thyroid tissue, Id-2 expression was more variable. No significant differences were observed between histologic subtypes of thyroid carcinomas with respect to Id-1 or Id-2 expression. Follicular adenomas showed higher expressions of Id-1 and Id-2 than thyroid carcinomas. No significant association was found between clinicopathological parameters and Id-1 expression, though Id-2 expression was significantly reduced in metastatic, stage IV tumors.
CONCLUSION
The expressions of Id-1 and Id-2 were elevated in hyperplastic and neoplastic thyroid tissues. However, neither appears suitable as a marker of malignancy or an aggressive phenotype, although Id-2 expression in advanced thyroid carcinomas may reflect a favorable prognosis.

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