scholarly journals Diagnostic value of CD56 immunohistochemistry in thyroid lesions

2018 ◽  
Vol 33 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Jung-Soo Pyo ◽  
Dong-Hoon Kim ◽  
Jungho Yang
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Hashimoto’S Thyroiditis ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Cd56 Expression ◽  
Thyroid Lesions

Purpose: The present study aimed to evaluate the diagnostic roles of CD56 immunohistochemistry in differentiating various thyroid lesions. Methods: A meta-analysis was performed to evaluate the rate of loss of CD56 immunohistochemistry expression from 13 eligible studies regarding various thyroid lesions, including papillary thyroid carcinoma, follicular carcinoma, and follicular adenoma. To confirm the value of CD56 immunohistochemistry in differentiating various thyroid lesions, a diagnostic test accuracy review was conducted. Results: An 87.8%, 79.1%, 11.9%, 25.5%, and 19.6% loss of CD56 immunohistochemistry expression was identified in papillary thyroid carcinoma, follicular carcinoma, follicular adenoma, benign follicular nodule, and Hashimoto’s thyroiditis, respectively. In the normal thyroid tissue, the rate of loss of CD56 expression was 1.6%. Classical, follicular, diffuse sclerosing, tall cell, and encapsulated variants of papillary thyroid carcinoma showed an 88.4%, 75.3%, 97.2%, 91.7%, and 91.7% loss of CD56 expression, respectively. In the comparison between the follicular variant of papillary thyroid carcinoma and follicular adenoma, the pooled sensitivity and specificity of CD56 immunohistochemistry was 0.82 (95% confidence interval (CI) 0.70, 0.90) and 0.94 (95% CI 0.83, 0.99), respectively. The diagnostic odds ratio and the area under curve on summary receiver operating characteristic curve was 51.43 (95% CI 5.83, 453.88) and 0.9387, respectively. Conclusion: Collectively, these results indicate that the rate of loss of CD56 immunohistochemistry expression was significantly higher in malignant tumors, such as papillary thyroid carcinoma and follicular carcinoma, than in follicular adenoma, benign follicular nodule, and Hashimoto’s thyroiditis. As such, CD56 immunohistochemistry can be useful in differentiating follicular variant papillary thyroid carcinoma from follicular adenoma.

scholarly journals Follicular Variant of Papillary Thyroid Carcinoma on the Basis of His-topathological and Immunohistochemical Diagnosis

2017 ◽  
Vol 42 (1) ◽  
pp. 21-27
Author(s):  
Mohammad Mosiur Rahman ◽  
Sultana Gulshan Banu ◽  
Ashim Ranjan Barua ◽  
Mohammed Kamal ◽  
Muhammod Nazmul Baqui ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Diagnostic Accuracy ◽  
Papillary Carcinoma ◽  
Follicular Adenoma ◽  
Minor Component ◽  
Follicular Carcinoma ◽  
Papillary Thyroid ◽  
Medical Surveillance ◽  
Follicular Variant

A significant increase in incidence of papillary thyroid carcinoma (PTC) has been noticed in recent decades worldwide. This is due to advances in medical surveillance, increased use of ancillary tests, and a minor component due to over diagnosis of PTC. Follicular variant of papillary thyroid carcinoma (FVPTC) is the second most common variant of PTC and comprises about 23-41%. It is difficult to diagnose histologically when the distinctive nuclear features are either not well developed or present focally within the lesion. Several immunohistochemical markers (CD56, HMCK, GAL3, HBME-1 and CK19) either alone or combined in panels can be used to improve diagnostic accuracy. This study was aimed to differentiate FVPTC from other follicular patterned lesion of thyroid by histopathology and immunohistochemistry (IHC). A total of 50 histologically diagnosed cases of thyroid neoplasm were studied. The neoplastic cases included 40 cases of follicular variant papillary carcinoma (FVPC), 04 classic papillary carcinoma (PTC), 04 follicular carcinoma and 02 follicular adenoma. All cases were evaluated by IHC for the expression of CD56 and CK19 antibody. In case of FVPTC (n=40), 21 cases (52.5%) were CK19 positive and CD56 negative as expected. Both markers were found positive in 06 (15%) cases and CD56+ alone was found positive in 11 (27.5%) cases of FVPTC, and a finding that goes against the diagnosis of FVPTC. The histopathological slides of these cases were reviewed and findings were recorded. All cases (n=4) of classic PTC were CK19 positive and 03 (75%) cases were found CD56 negative. Diagnoses of thyroid follicular lesions are primarily based on histological and cytomorphological criteria. However, there was a subset of follicular patterned tumors like FVPTC which lack unequivocal features of malignancy. Immunohistochemistry can improve diagnostic accuracy but needs additional studies for controversial cases. It may be considered these lesions as differentiated tumor of uncertain malignant potential (WDT-UMP) to avoid the using term carcinoma. Additional studies are needed for establishing more precise morphologic criteria and for identifying useful markers for differentiating benign from borderline or malignant thyroid lesions.

scholarly journals CD56 Expression in Papillary Thyroid Carcinoma is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall

2020 ◽  
Author(s):  
Uiju Cho ◽  
Yourha Kim ◽  
Sora Jeon ◽  
Chan Kwon Jung
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Adenoma ◽  
Analysis Tool ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Aberrant Expression ◽  
Histologic Subtype ◽  
Diagnostic Pitfall ◽  
Cd56 Expression

Abstract Background Loss of CD56 expression has been regarded as a diagnostic marker of papillary thyroid carcinoma (PTC). However, certain variants of PTC can aberrantly express CD56. Methods Using a digital-image analysis tool, we evaluated H-scores of CD56 immunostaining in 216 thyroid tumors. Results The H-score of the CD56 of all PTCs was lower than that of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (p < 0.001). The H-scores of CD56 were lower in classic PTC, the infiltrative follicular variant, and the diffuse sclerosing variant than in other PTC variants (p < 0.001), whereas the H-scores were higher in tall cell variant, Warthin-like variant, and cribriform-morular variant than in classic PTC (p < 0.001). The optimal cut-off value of H-scores for the CD56 expression was 180 for differentiating the NIFTP from the follicular adenoma and 30 for the differential diagnosis of NIFTP and infiltrative follicular variant PTC. Conclusions CD56 expression is predominantly lost in classic and infiltrative follicular variants of PTCs and more preserved in the other histologic subtypes of PTC and NIFTP. CD56 is particularly useful for differentiating PTC from follicular-pattern thyroid neoplasms, but the aberrant expression in uncommon variants of PTC could be a diagnostic pitfall.

scholarly journals Papillary Thyroid Carcinoma Arising in Children and Adolescent Hashimoto’s Thyroiditis: Ultrasonographic and Pathologic Findings

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sun Hye Jeong ◽  
Hyun Sook Hong ◽  
Eun Hye Lee ◽  
Jeong Ja Kwak
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Hashimoto’S Thyroiditis ◽  
Extrathyroidal Extension ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Node Metastases

Objectives. We compared the ultrasonography and pathology features of papillary thyroid carcinoma (PTC) in pediatric and adolescents with Hashimoto’s thyroiditis (HT) with those of non-HT patients.Materials and Methods. Eleven patients who were surgically confirmed to have pediatric or adolescent PTC from 2006 to 2014 were included in this study. We retrospectively analyzed the preoperative ultrasonography and pathology features of PTC arising in HT and non-HT patients.Results. On ultrasonography, thyroid gland was lobulated and enlarged, with many scattered microcalcifications in four of five HT patients. Four of six non-HT patients had suspicious masses with calcifications. The diffuse sclerosing variant of PTC (DSVPTC) was found in three of five HT patients, but none in non-HT patients. Macroscopic or microscopic extrathyroidal extension was evident in all of the HT patients and four of the non-HT patients. Neck lymph node metastases were in all HT patients and five of non-HT patients.Conclusions. Three of five PTCs in pediatric and adolescent HT patients were DSVPTC, whereas all PTCs of the non-HT patients were classic type. On ultrasonography, thyroid gland was diffusely enlarged with scattered microcalcifications in four of five HT patients. All five HT cases had aggressive disease, including extrathyroidal extension and cervical lymph node metastases.

BRAFK601E Mutation in a Follicular Thyroid Adenoma: A Case Report

2017 ◽  
Vol 25 (4) ◽  
pp. 348-351 ◽  
Author(s):  
Elisabetta Macerola ◽  
Liborio Torregrossa ◽  
Clara Ugolini ◽  
Sohail Bakkar ◽  
Paolo Vitti ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Treatment Plan ◽  
Follicular Adenoma ◽  
Surrounding Tissue ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Thyroid Lesion ◽  
Cytological Smear ◽  
Benign Thyroid

BRAF mutations represent the most common genetic alteration in papillary thyroid carcinoma (PTC). The p.V600E mutation is specific for the classic and tall-cell variants of PTC and has been associated with a more aggressive biologic behavior. On the other hand, the p.K601E mutation is peculiar to the follicular variant of PTC, and seems to be a favorable prognostic indicator. A 12-year-old boy presented with a 10-mm left-sided thyroid nodule. Fine-needle aspiration cytology reported the lesion as suspicious for a follicular neoplasm (Bethesda category IV). The patient underwent lobectomy, and histopathology revealed a follicular adenoma with normal surrounding tissue. The cytological smear was found to be positive for BRAF p.K601E mutation, and this was later confirmed on the corresponding paraffin block. This case was independently revised by 4 expert pathologists, all of whom confirmed the benign nature of the thyroid lesion. This article describes the presence of a BRAF mutation in a benign thyroid lesion. To the authors’ knowledge, this is the fourth case of follicular adenoma carrying BRAFK601E reported in literature to date. BRAFK601E mutation can occur in benign thyroid lesions. This finding, in the context of the current literature and the recently proposed reclassification of the noninvasive encapsulated follicular variant of papillary thyroid carcinoma into a benign lesion, confirms the importance of preoperative BRAF p.K601E testing in offering patients a tailored treatment plan and avoiding overtreatment.

Immunohistochemical Separation of Follicular Variant of Papillary Thyroid Carcinoma from Follicular Adenoma

2006 ◽  
Vol 17 (3) ◽  
pp. 213-224 ◽  
Author(s):  
Nobuki Nakamura ◽  
Lori A. Erickson ◽  
Long Jin ◽  
Sabine Kajita ◽  
Heyu Zhang ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Adenoma ◽  
Papillary Thyroid ◽  
Follicular Variant
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