Value of cytokeratin-19, Hector Battifora mesothelial-1 and galectin-3 immunostaining in the diagnosis of thyroid neoplasms

Abstract BACKGROUND: Diagnosis of types and aggressiveness of thyroid cancers is difficult. The "gold standard" in diagnosis is using routine hematoxylin and eosin staining. Several markers have been investigated for differentiating them among which cytokeratin-19 (CK-19), Hector Battifora mesothelial cell (HBME-1), and galectin-3 are found to be most commonly used. Most studies have evaluated the single expression of markers in various thyroid lesions. AIMS AND OBJECTIVES: To know the value of immunohistochemical expression of CK-19, HBME-1, and galectin-3 in diagnosing thyroid neoplasms. To study the expression and compare the results of HBME-1, CK-19, and galectin-3 immunohistochemical markers in histopathologically diagnosed malignant lesions and nonmalignant lesions and demonstrate their usefulness in differentiating them. MATERIALS AND METHODS: A prospective study was carried out on thyroidectomy specimens sent in 10% buffered formalin to Department of Pathology, SVIMS, Tirupati, from May 2013 to August 2014. Sensitivity and specificity for each marker and their combination in diagnosis were calculated. RESULTS: Among 120 cases, nonmalignant lesions were 70 (58.33%) and malignant lesions 50 (41.67%). Among nonmalignant lesions, 65 (93%) were adenomatous goiter and 5 (7%) were follicular adenomas. In malignant lesions, 48 (96%) were papillary carcinoma and 1 (2%) each of follicular carcinoma and anaplastic carcinoma. Among papillary carcinomas, classical were 26 (54.16%) followed by 17 follicular variant (35.41%). Galectin-3 had highest sensitivity of 90% and HBME-1 had highest specificity of 97.14%. CONCLUSIONS: Panel of HBME-1+ galectin-3 or CK-19, HBME-1, and galectin-3 increase the accuracy of diagnosis in histopathologically difficult cases.

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The Role of Cell Blocks and Immunohistochemistry in Thyroid Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Bethesda Category

Acta Cytologica ◽

10.1159/000514906 ◽

2021 ◽

pp. 1-7

Author(s):

Mikk Abram ◽

Roope Huhtamella ◽

David Kalfert ◽

Heli Hakso-Mäkinen ◽

Marie Ludvíková ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Diagnostic Workup ◽

Cytokeratin 19 ◽

Thyroid Cytology ◽

Immunohistochemical Markers ◽

Galectin 3 ◽

Nodular Lesions ◽

Undetermined Significance

Introduction: Thyroid cytology is a widely accepted tool in the clinical triaging of nodular lesions. Cell blocks (CBs) can help in the diagnosis of atypical lesions, namely, thyroid Bethesda category of Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). Methods: In a series of 224 AUS/FLUS thyroid samples with CB, we studied CB cellularity and feasibility of 3 immunohistochemical markers (cytokeratin 19 [CK19], HBME-1, and galectin-3) apart and in combination. Results: The CBs were non-diagnostic in 34 cases. Twenty-four CBs contained <10 cells, 45 CBs 10–50 cells, and 121 CBs >50 cells. Notably, more cellularity was found in CBs performed by plasma-thrombin and in-house techniques (p < 0.001). The diagnostic accuracy to detect malignancy was 65.1% for CK19, 72.1% for HBME-1, and 70.3% for galectin-3. Conclusion: In conclusion, CB cellularity is essential for successful immunohistochemistry application and further diagnostic workup of AUS/FLUS cases.

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Role of p27 in differentiating follicular adenoma and follicular carcinoma of the thyroid

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20210883 ◽

2021 ◽

Vol 9 (3) ◽

pp. 812

Author(s):

Bimanjyoti Deuri ◽

Musfika Tabassum ◽

Nandinee Lahkar

Keyword(s):

Follicular Adenoma ◽

Follicular Carcinoma ◽

Immunohistochemical Analysis ◽

Thyroid Neoplasms ◽

Thyroid Function Tests ◽

Cell Cycle Protein ◽

Over Expression ◽

Malignant Lesions ◽

Malignant Thyroid Neoplasms

Background: Thyroid neoplasms represent a broad spectrum of tumors with different biologic behaviour. Although investigations like thyroid function tests, scintigraphy and ultrasonography were routinely used for the diagnosis of thyroid nodules, they could not discriminate between benign and malignant lesions. The present study is undertaken to assess the expression of cell cycle protein such as p27kip1 (p27) in thyroid neoplasms which might be useful in predicting behaviour of various thyroid neoplasms and aid in their diagnosis. Aim of the study was to assess the expression of p27 and its role in differentiating follicular adenoma and follicular carcinoma of the thyroid.Methods: The present study was undertaken to evaluate the expression of p27 in thyroid neoplasms with the help of immunohistochemical analysis over a period of 1 year. The study was conducted on archival blocks retrieved from the Department of Pathology, SMCH. 19 thyroid neoplasms were diagnosed (7 benign, 12 malignant) and IHC expression of p27 was studied.Results: There was over-expression of p27 staining in case of follicular adenoma whereas malignant lesions showed underexpression on p27 staining. P27 expression was significantly different in follicular adenoma and follicular carcinoma of the thyroid.Conclusions: The role of p27 in differentiating benign and malignant thyroid neoplasms may prove it to be a candidate marker if combined with other additional investigations like radionuclide scan or using a broad panel of IHC markers. This may provide more insight into the behaviour of tumors in a detailed manner.

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Histomorphological study of malignant thyroid neoplasm in a tertiary care center and evaluation of Galectin 3 expression in papillary thyroid carcinoma

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl2.2222 ◽

2020 ◽

Vol 11 (SPL2) ◽

pp. 220-227

Author(s):

Nithin Diwagar K ◽

Sridevi M ◽

Chitra S

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Tumour Progression ◽

Care Center ◽

Tertiary Care ◽

False Negative ◽

Thyroid Neoplasms ◽

Anaplastic Carcinoma ◽

Papillary Thyroid ◽

Galectin 3

Galectin-3 is a beta-galactoside binding animal lectin, which is frequently associated with tumour progression and metastasis. In recent years, overexpression of Galectin-3 has been reported in various human cancers and more frequently in thyroid neoplasms. The aim of this study was to analyze the histomorphological characteristics of malignant thyroid neoplasms, subtype them according to the established classification system and to evaluate the expression of Galectin-3 immunostaining in papillary thyroid carcinoma. A total of 30 cases were included in the study, out of which 28 cases were papillary thyroid carcinoma and its variants and one case of medullary and anaplastic carcinoma. Majority of the papillary thyroid carcinoma cases were positive for Galectin 3 immunostaining (25/28 cases – 89%) in our study. We conclude that galectin-3 is consistently expressed in papillary carcinoma thyroid; however, there are few false-negative cases in this study and also other studies have reported Galectin 3 overexpression in non-papillary tumors. Hence, we cannot depend on Galectin 3 expression alone as a single diagnostic tool to detect papillary thyroid carcinoma.

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Galectin-3 Immunohistochemical Expression in Thyroid Neoplasms – A Study from Kalaburagi, Karnataka

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/427 ◽

2021 ◽

Vol 8 (26) ◽

pp. 2288-2293

Author(s):

Anuradha G. Patil ◽

Saniya Jahan ◽

Syed Mukhtar Mohiuddin

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Follicular Carcinoma ◽

Thyroid Neoplasms ◽

Malignant Neoplasms ◽

Benign Neoplasms ◽

Papillary Thyroid ◽

Follicular Variant ◽

Galectin 3 ◽

Malignant Thyroid Neoplasms

BACKGROUND Thyroid carcinoma is the most common endocrine malignancy. Galectin-3 has been implicated in malignant transformation and metastasis of cancer cells and it has received notable recognition for its usefulness as a diagnostic marker for thyroid cancer. We wanted to evaluate the expression of Galectin-3 on thyroid neoplasms, establish its diagnostic accuracy and also differentiate between benign and malignant thyroid lesions. METHODS A total of 54 thyroidectomy specimens were studied over a period of 3 years (2016 - 2019) which included 20 benign and 34 malignant thyroid neoplasms. Histopathologic evaluation of H & E stained sections was done and immunohistochemistry (IHC) staining for Galectin-3 was performed for all neoplasms with the polymeric method using lyophilized mouse monoclonal antibody. (Path n Situ) and grading based on intensity of Galectin-3 expression were noted. RESULTS Galectin-3 expression was significantly higher (P < 0.001) in malignant thyroid neoplasms in comparison to the benign neoplasms. Galectin-3 expression for malignant neoplasms showed sensitivity of 88.23 %, specificity of 95.0 %, positive predictive value (PPV) of 96.8 % and negative predictive value (NPV) of 82.6 %. Galectin-3 expression in Papillary thyroid carcinoma showed a sensitivity of 95.83 % and PPV of 88.2 %. While comparing the neoplasms showing follicular pattern, Galectin-3 expression was more in the malignant neoplasms (follicular carcinoma and follicular variant of papillary carcinoma thyroid) than benign neoplasms (follicular adenoma). CONCLUSIONS Galectin-3 is a useful marker in differentiating benign and malignant thyroid neoplasms. Galectin-3 is sensitive for Papillary thyroid carcinoma (PTC) and among the follicular patterned lesions, Galectin-3 is sensitive for follicular variant of papillary carcinoma and follicular carcinoma. Thus Galectin-3 protein expression evaluated using immunohistochemistry technique acts as an adjunctive ancillary technique in thyroid cancer diagnosis. KEYWORDS Galectin-3, Immunohistochemistry, Thyroid Carcinoma, Papillary Thyroid Carcinoma

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Galectin-3 immunodetection in follicular thyroid neoplasms: a prospective study on fine-needle aspiration samples

British Journal of Cancer ◽

10.1038/sj.bjc.6602822 ◽

2005 ◽

Vol 93 (10) ◽

pp. 1175-1181 ◽

Cited By ~ 39

Author(s):

J F Collet ◽

I Hurbain ◽

C Prengel ◽

O Utzmann ◽

F Scetbon ◽

...

Keyword(s):

Prospective Study ◽

Fine Needle Aspiration ◽

Thyroid Neoplasms ◽

Needle Aspiration ◽

Fine Needle ◽

Galectin 3 ◽

A Prospective Study

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Histopathological and immunohistochemical features of thyroid carcinoma

Archive of oncology ◽

10.2298/aoo0303173t ◽

2003 ◽

Vol 11 (3) ◽

pp. 173-174 ◽

Cited By ~ 4

Author(s):

Svetislav Tatic

Keyword(s):

Thyroid Carcinoma ◽

Malignant Tumors ◽

Follicular Carcinoma ◽

Medullary Carcinoma ◽

Needle Aspiration ◽

Anaplastic Carcinoma ◽

Follicle Cells ◽

Tumor Capsule ◽

Immunohistochemical Markers ◽

Amyloid Deposits

Thyroid-specific malignant tumors are derived from follicle cells (papillary and follicular carcinoma), and from parafollicular, calcitonin-producing C-cells (medullary carcinoma). The main criterion for diagnosis of papillary carcinoma is the occurrence of ground glass, hypochromic nuclei, often associated with papillae as the prominent pattern of the tumor, and psammoma bodies. The diagnosis of follicular carcinoma is based on the true infiltration of the venous vessels outside the tumor capsule and the fungus-like infiltration through the tumor capsule into the surrounding parenchyma. Anaplastic carcinoma is mostly detected by the pathologist by fine-needle aspiration biopsy, or tumor reduction specimen. Medullary thyroid carcinoma is typically composed of solid nests and infiltrating formations of polygonal or spindle-shaped cells and amyloid deposits within the stroma of the tumor. Two main discriminatory immunohistochemical markers for tumors with follicular and parafollicular origin are thyroglobulin and calcitonin, respectively. Thyroglobulin is present in more than 95% of papillary and follicular carcinomas, whereas anaplastic thyroid carcinomas are mostly immunonegative for thyroglobulin. Medullary carcinoma is characteristically positive for calcitonin, pan-neuroendocrine markers, and often numerous peptides.

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Clinico-histopathological Assessment of Patients Undergoing Thyroidectomy

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i630452 ◽

2020 ◽

pp. 96-101

Author(s):

Rasool Bux Behan ◽

Agha Taj Mohammed ◽

Bilal Rasool ◽

Mujeeb-Ur-Rehman Laghari

Keyword(s):

Papillary Carcinoma ◽

Tertiary Care ◽

Histological Finding ◽

Follicular Carcinoma ◽

Anaplastic Carcinoma ◽

Care Hospital ◽

Thyroid Disorder ◽

Diagnostic Laboratory ◽

Cross Sectional ◽

Adenomatous Goiter

Objective: To determine the clinical presentation and histopathological evaluation of patients undergoing thyroidectomies at tertiary care Hospital. Methodology: This cross-sectional study was done at department of general surgery of LUMHS/Jamshoro. Duration of the study was 1 year from October 2017 to September 2018. All the cases with a diagnosis of thyroid disorder and underwent thyroidectomy were selected and above 25 years of the age were included. All the surgeries were carried out by senior surgeons along with the cooperation of the ENT surgeons. After surgeries specimens of all the cases were sent to the diagnostic laboratory for the histological assessment. Data was collected via self-made proforma. Results: Of 58 patients majority i.e. 43.10% were found with age group of 35-44 years. Females found in the majority 63.80%. The swelling was noted among all of the cases, followed by pain, difficulty in swallowing, difficulty in breathing and others 8.62%, 10.34%, 20.68% and 25.68% respectively. Adenomatous goiter was the most common histopathological finding in 82.75% cases, papillary carcinoma was found 8.62%, follicular carcinoma was only in one case and anaplastic carcinoma was also in 1 case. Conclusion: Swelling, difficulty in swallowing and difficulty in breathing were the most common clinical features. Adenomatous goiter was the most common histological finding and papillary carcinoma was the commonest malignancy.

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Raman Spectroscopy Discloses Altered Molecular Profile in Thyroid Adenomas

Diagnostics ◽

10.3390/diagnostics11010043 ◽

2020 ◽

Vol 11 (1) ◽

pp. 43

Author(s):

Armida Sodo ◽

Martina Verri ◽

Andrea Palermo ◽

Anda Mihaela Naciu ◽

Marialuisa Sponziello ◽

...

Keyword(s):

Raman Spectroscopy ◽

Thyroid Nodules ◽

Thyroid Neoplasms ◽

Molecular Profile ◽

Molecular Fingerprint ◽

Extensive Evaluation ◽

Associated Proteins ◽

Thyroid Adenomas ◽

Malignant Lesions ◽

Nuclear Features

Follicular patterned nodules are sometimes complex to be classified due to ambiguous nuclear features and/or questionable capsular or vascular invasion. In this setting, there is a poor inter-observer concordance even among expert pathologists. Raman spectroscopy was recently used to separate benign and malignant thyroid nodules based on their molecular fingerprint; anyway, some histologically proved follicular adenomas were clustered as having a characteristic profile of malignant lesions. In this study, we analyzed five follicular thyroid adenomas with a malignant spectroscopic profile compared to five follicular adenomas with a benign Raman spectrum in order to assess possible molecular differences between the two groups. Morphological, immunohistochemical, and molecular analyses evidenced expression of malignancy-associated proteins in four out of five malignant clustered adenomas. The remaining malignant clustered adenoma showed a TSHR mutation previously associated with autonomously functioning follicular carcinomas. In conclusion, thyroid follicular adenomas are a group of morphologically benign neoplasms that may have altered the mutational or expression profile; cases of adenomas with altered immunophenotype are recognized as showing a profile associated with malignancy by Raman spectroscopy. This correlation warrants a more extensive evaluation and suggests a potential predictive value of spectroscopic assessment in recognizing characteristics associated with tumor progression in follicular thyroid neoplasms.

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Lymphocytic Infiltration in Pediatric Thyroid Carcinomas

Pediatric and Developmental Pathology ◽

10.1007/s10024-003-3028-3 ◽

2004 ◽

Vol 7 (5) ◽

pp. 487-492 ◽

Cited By ~ 10

Author(s):

Van H. Savell ◽

Stephen M. Hughes ◽

Charles Bower ◽

David M. Parham

Keyword(s):

Papillary Carcinoma ◽

Follicular Carcinoma ◽

Thyroid Neoplasms ◽

Lymphocytic Infiltration ◽

Lymphocytic Infiltrate ◽

Low Grade ◽

Lymphoid Infiltrate ◽

Thyroid Carcinomas ◽

Thyroid Papillary ◽

Adults And Children

Lymphocytic thyroiditis has been associated with an increase in the incidence of thyroid papillary carcinoma in some reports, mostly series of both adults and children. Relatively little is written about thyroiditis and follicular carcinomas. We have seen several cases of pediatric follicular thyroid carcinomas, that had an associated lymphocytic infiltrate, which led us to examine all primary malignant thyroid neoplasms in our surgical files from 1984 through 2000 to examine this relationship. We also investigated the nature of the lymphocytic infiltrate with routine immunohistochemistry. Ten patients (five male, five female, ages 4.5–21 years of age) had a thyroid carcinoma resection, six (three males and three females) with papillary carcinoma and four patients (two males and two females) with low-grade follicular carcinoma. Seven samples (one male had two cases with tumor) from patients who had a papillary carcinoma resection with tissue blocks available were identified (one patient had slides but no blocks), as were all four patients with a follicular carcinoma. The thyroid of all patients with a follicular carcinoma contained a lymphocytic infiltrate; only four of the seven papillary carcinoma samples had an associated lymphoid infiltrate. In all cases with a lymphoid infiltrate, the infiltrate was present in both lobes (both adjacent and separate from the tumor). B lymphocytes were present in the lymphoid infiltrate of three of four patients with follicular carcinomas and in 1 of 3 cases of papillary carcinomas. T cells were dispersed throughout all the tumors with lymphoid infiltrates. We conclude that pediatric follicular carcinomas have an associated lymphocytic infiltrate in the tumor and/or adjacent thyroid, more commonly than papillary carcinomas.

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