Abstract | CONTEXT: Prophylactic thyroidectomies are increasingly performed on patients at risk for developing medullary thyroid carcinoma (MTC); consequently, pathologists are more commonly encountering these specimens in routine practice. OBJECTIVE: DESIGN: RESULTS: Patients included 22 men and 20 women (mean age, 26.2 years). Among those with known RET proto-oncogene mutations, affected sites included exons 10, 11, 14, and 16. In 93% (n = 39) of cases, either C-cell hyperplasia (n = 36), medullary microcarcinoma (MMC; n = 29), or medullary macrocarcinoma (n = 1) was found. C-cell hyperplasia was often multifocal ( n = 30) and bilateral (n = 23) and included both nonnodular and nodular patterns. A total of 94% of C-cell hyperplasia cases and all MMC cases were microscopically detectable using hematoxylin- eosin stains. The MMCs were characterized by a complex microarchitectural pattern with a desmoplastic stromal response (n = 29) and focal amyloid deposition (n = 12). Most MMCs exhibited a solid pattern (n = 24) of round, polygonal, spindled, or plasmacytoid-shaped cells. Only 1 case of MMC showed evidence of metastatic disease to a pretracheal lymph node. CONCLUSIONS: Based upon our clinicopathologic findings and review of the literature, we conclude that thyroidectomies in at-risk patients are very frequently associated with C-cell hyperplasia and/or MMC; however, the clinical prognosis for these patients is very good.
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Authors | Demet Etit, William C Faquin, Randall Gaz, Gregory Randolph, Ronald A DeLellis, Ben Z Pilch |
Journal | Archives of pathology & laboratory medicine
(Arch Pathol Lab Med)
Vol. 132
Issue 11
Pg. 1767-73
(Nov 2008)
ISSN: 1543-2165 [Electronic] United States |
PMID | 18976013
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- MAS1 protein, human
- Proto-Oncogene Mas
- Calcitonin
- Proto-Oncogene Proteins c-ret
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Topics |
- Adolescent
- Adult
- Aged
- Calcitonin
(blood)
- Carcinoma, Medullary
(pathology, prevention & control, surgery)
- Child
- Child, Preschool
- Female
- Humans
- Hyperplasia
(pathology)
- Lymph Nodes
(pathology)
- Male
- Middle Aged
- Mutation
(genetics)
- Parathyroid Glands
(pathology)
- Proto-Oncogene Mas
- Proto-Oncogene Proteins c-ret
(genetics)
- Retrospective Studies
- Thyroid Gland
(pathology, surgery)
- Thyroid Neoplasms
(pathology, prevention & control, surgery)
- Thyroidectomy
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