Clear cell change in primary thyroid tumors

Carcangiu, Maria L.; Sibley, Richard K.; Rosaí, Juan

doi:10.1097/00000478-198510000-00002

Cited by 148 publications

(101 citation statements)

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“…The signet ring morphology in these tumors is due to the accumulation of intracytoplasmic mucin, resulting in nuclear compression. In addition to signet ring adenocarcinomas, signet ring cells have also been described in many other neoplasms, such as adenoma and carcinoma of the thyroid, lymphoma, cutaneous neoplasms, gastrointestinal stromal tumor, and stromal tumor of the ovary (2)(3)(4)(5)(6). Signet ring cell changes in the latter tumor types are usually due to intracellular accumulation of various materials other than mucin.…”

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confidence: 99%

Collecting-Duct Carcinoma of the Kidney with Prominent Signet Ring Cell Features

Vuolo

Weidenheim

et al. 2001

Modern Pathology

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We report a case in a 74-year-old woman of collecting-duct carcinoma of the kidney with prominent signet ring cell features. Grossly, the tumor measured 5.5 cm in greatest dimension, occupied the entire upper pole of the kidney, and was well circumscribed. Microscopically, it displayed a predominant tubulopapillary pattern of growth with a hyalinizing stroma. The tumor tubules were lined by a single layer of cells with large, pleomorphic nuclei, some of which had a hobnail appearance. Large intracytoplasmic vacuoles with compression of nuclei (signet ring cells) were present throughout the tumor. Alcian blue, mucicarmine, and periodic acid-Schiff stains failed to identify intracellular mucin or glycogen in the signet ring cells. Enlarged cells with intracytoplasmic vacuoles were also noted in the adjacent collecting ducts. The tumor cells were immunohistochemically positive for cytokeratin including cytokeratin 7, CAM 5.2, AE1/3, and 34␤E12, vimentin, peanut lectin agglutinin, and Ulex europaeus agglutinin. Electron microscopy revealed that the intracytoplasmic vacuoles were due to intracellular edema. To the best of our knowledge, this is the first reported case of renal collecting-duct carcinoma with prominent signet ring cell features.

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confidence: 99%

Collecting-Duct Carcinoma of the Kidney with Prominent Signet Ring Cell Features

Vuolo

Weidenheim

et al. 2001

Modern Pathology

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“…The etiology of this clear cell change (sometimes leading to the formation of signet ring cells) has been ascribed to a variety of factors, including the accumulation of cytoplasmic vesicles, glycogen, mucin, lipid, and even thyroglobulin in some examples (15). Clear cell change rarely is described in cytopathologic descriptions of primary thyroid neoplasms, and when present one is more apt to be dealing with a metastatic tumor.…”

Section: Discussionmentioning

confidence: 99%

Aspiration Cytopathology of Metastatic Mucinous Papillary Thyroid Carcinoma

Morrison

Wakely

2001

Modern Pathology

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The light microscopic histopathology and cytopathology of papillary thyroid carcinoma (PTC) and its variants is amply depicted in reviews, books, and book chapters. One of the changes in PTC, however, that is infrequently discussed or illustrated in the literature is that of mucinous metaplasia. In the aspiration cytopathology literature, we are aware of only a rare report of PTC exhibiting extensive mucinous metaplasia. We present an example correlating the histopathology and fine needle aspiration cytopathology of a PTC that had metastasized on several separate occasions to cervical lymph nodes, and in the process demonstrated mucinous trans- The presence of mucin in endocrine neoplasms is an unexpected finding in contrast to its frequent production in non-endocrine epithelial tumors. This can assume diagnostic importance if the pathologist is asked to determine the site of a mucin-producing metastatic carcinoma in a patient with either an unknown primary or a remote history of cancer. Almost four decades ago, in a large study of the surgical pathology of various metastatic neoplasms (including 93 examples of thyroid cancer), Foster et al. concluded that "the thyroid is the only site studied that can be ruled out with great assurance when one is dealing with a mucicarmine positive metastasis" (1). Although reports to the contrary have been published (2-4), our impression is that many pathologists remain under the misconception that carcinomas of the thyroid are nearly all mucin-negative. This assumption from histopathology has been transferred to fine needle aspiration (FNA) cytopathology of thyroid carcinoma, where only rare descriptions or illustrations of extracellular mucin or mucin-filled vacuoles exist (5, 6). The aim of this article is to illustrate and describe the FNA cytopathology (and corresponding histopathology) of a mucinous papillary thyroid carcinoma (PTC) and to discuss the potential pitfalls related to this phenomenon. CASE REPORTA 66-year-old man had undergone complete thyroidectomy at an outside hospital for PTC 10 years earlier after an initial right cervical lymph node biopsy revealed metastatic disease. Over the past decade, he has received three courses of radioactive iodine therapy and has had two separate surgical procedures to excise repeatedly enlarged right neck lymph nodes. On each occasion these nodes contained metastatic PTC both within the node proper and in extranodal soft tissue. No metastasis beyond the right cervical lymph node group has ever been detected.He presented to our medical center because of a third recurrence of right cervical lymphadenopathy since his initial thyroidectomy. FNA biopsy of an enlarged right cervical lymph node was performed and revealed metastatic carcinoma. Subsequent surgical resection of the aspirated node and surrounding soft tissue was performed 2 weeks after FNA confirmed that diagnosis. One year after the FNA, he presented with a fourth recurrence of a right neck mass. This was excised without performing another prior FNA, and again it reve...

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“…Rarely, clear cell change is seen in lipid-rich cell adenoma, where accumulation of neutral fat results in cytoplasmic vacuolation 10 . Cytoplasmic clear cell changes are also seen in dyshormonogenetic goiter and hashimotos thyroiditis which are nonneoplastic thyroid disorders 11 . Main differential diagnosis of primary thyroid tumors with clear cells change is with Metastatic Renal cell carcinoma 12 and Parathyroid neoplasms.…”

Section: Case History:-mentioning

confidence: 99%

Follicular Adenoma Thyroid With Clear Cell Changes- A Rare Case Report.

Gupta¹,

Gupta²,

Lal³

et al. 2016

IJAR

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Follicular lesions in thyroid nodule are common findings while investigating them by fine-needle aspiration cytology (FNAC). Histologically, these lesions may represent a cellular nodule in a goiter, a follicular adenoma, or a carcinoma. Cellular changes that occur in clear cytoplasm in thyroid lesions are caused by glycogenation, intracellular accumulation of thyroglobulin, dialatation and hypertrophy of mitochondrial cells and golgi complex hypertrophy which is due to excessive secretion of Thyroid stimulating hormone(TSH). A 28 year female, housewife, presented with a gradually increasing swelling in midline of neck since 2 years. On examination, swelling was present on anterior border of sternocledomastoid, 3x2cm in size, oval and with diffuse margins. It was non-tender, moved on deglutition, non-reducible and transillumination negative. The patient had normal thyroid functions with free T4 and TSH within normal range. No capsular or vascular invasion was seen. A diagnosis of Clear cell Follicular adenoma thyroid was made. Pure Follicular adenomas are the common lesions of thyroid and arise from follicular epithelium. They are usually single and well-encapsulated lesions. These lesions are more common in females and are mostly benign. Any thyroid lesion with clear cell features warrants further histopathological assessment as clear cell changes are not appreciated in cytological smears. Our case presents the pathology of pure clear cell Follicular adenoma which is rarely seen.Copy Right, IJAR, 2016,. All rights reserved.

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Clear cell change in primary thyroid tumors

Cited by 148 publications

References 0 publications

Collecting-Duct Carcinoma of the Kidney with Prominent Signet Ring Cell Features

Collecting-Duct Carcinoma of the Kidney with Prominent Signet Ring Cell Features

Aspiration Cytopathology of Metastatic Mucinous Papillary Thyroid Carcinoma

Follicular Adenoma Thyroid With Clear Cell Changes- A Rare Case Report.

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