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SEMINARIO DE XCVII REUNIÓN DE LAS ASOCIACIONES TERRITORIALES
DE LA SEAP Y DE PORTUGAL
--------
REUNIÃO DAS INTERDEPARTAMENTAIS DE ANATOMIA PATOLÓGICA
DE PORTUGAL E DO NORTE DE ESPANHA

18 y 19 de noviembre de 2005
OPORTO

HOSPITAL CLÍNICO UNIVERSITARIO DE SANTIAGO DE COMPOSTELA

L. Puñal, I. Abdulkader, C. Ruíz-Ponte, N. Caramés, R. Reyes, J. Forteza, J. Cameselle-Teijeiro
Departamento de Patología, Hospital Clínico Universitario, Santiago de Compostela, España

Resumen de la historia clínica:

Thirty-one year old female patient with nodular goiter. In the last two years she was submitted to four colon biopsies. One year ago she was submitted to colectomy with a diagnosis of Familial Adenomatous Polyposis.

Diagnóstico:

THYROID CARCINOMA ASSOCIATED WITH FAMILIAL ADENOMATOUS POLYPOSIS.

Discussão / Discusión /Discussion:

We report a case of cribriform-morular variant (C-MV) of papillary thyroid carcinoma (PTC) that was accompanied by a familial adenomatous polyposis (FAP) in a 31-year-old woman. Recently, the patient underwent a total thyroidectomy due to multinodular goiter. The surgical specimen weighed 123g. and transection revealed several solid, cystic, well-circumscribed lesions of up to 30 mm in diameter. Microscopically, five encapsulated tumors showing a mixture of cribriform, follicular, papillary, trabecular, solid and spindle cell patterns of growth, with morular foci were found. The cells were cuboidal or tall, with frequent nuclear pseudostratification and abundant eosinophilic cytoplasms. The nuclei were usually hyperchromatic, with grooving, pallor, and pseudoinclusions. Foci of capsular invasion were also observed. The cells were immunoreactive for thyroglobulin, TTF-1, EMA, high and low-molecular weight keratins, vimentin, neuron-specific enolase, bcl-2 and estrogen and progesterone receptors. Genetic analysis of tumor tissue and blood of the patient showed the same mutation in exon 15 at codon 586 of the APC gene. The C-MV of PTC is typically multifocal in cases associated with FAP but the tumors are ussually solitary in the sporadic counterpart of this type of neoplasm.

Bibliografía / Referências bibliográficas /References:

  1. Cameselle-Teijeiro J, Chan JK. Cribriform-morular variant of papillary thyroid carcinoma: a distinctive variant representing the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma? Mod Pathol 1999;12:400-411.
  2. Cameselle-Teijeiro J, Ruíz-Ponte C, Loidi L, Suárez-Peñaranda J, Baltar J, Sobrinho-Simões M. Somatic but not germline mutation of the APC gene in a case of cribriform-morular variant of papillary thyroid carcinoma. Am J Clin Pathol 2001;115:486-493.
  3. Cetta F, Montalto G, Gori M, Curia MC, Cama A, Olschwang S. Germline mutations of the APC gene in patients with familial adenomatous polyposis-associated thyroid carcinoma: results from a European cooperative study. J Clin Endocrinol Metab 2000;85:286-292.
  4. Chong J-M, Koshiishi N, Kurihara K, Kubono S, Kawai T, Fukuyama M. Aspiration and imprint cytopathology of thyroid carcinoma associated with familial adenomatous polyposis. Diagn Cytopathol 2000;23:101-105.
  5. Harach HR, Williams GT, Williams ED. Familial adenomatous polyposis associated thyroid carcinoma: a distinct type of follicular cell neoplasm. Histopathology 1994;25:549-561.
  6. Soravia C, Sugg SL, Berk T, et al. Familial adenomatous polyposis-associated thyroid cancer. A clinical, pathological, and molecular genetics study. Am J Pathol 1999;154:127-135.
  7. Xu B, Yoshimoto K, Miyaguchi A, Kuma S, Mizusawa N, Hirokawa M, Sano T. Cribriform-morular variant of papillary thyroid carcinoma: a pathological and molecular genetic study with evidence of frequent somatic mutations in exon of the b -catenin gene. J Pathol 2003;199:58-67.

 

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Última actualización: 20 de marzo de 2006