Signet Ring Cell Adenoma of the Thyroid: A Very Rare Entity

Yalta, Tülin; Elagöz, Şahande; Uyar, Meral; Topuz, Ömer; Özer, Hatice; Tuncer, Ersin

doi:10.1159/000252840

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…A mucin-containing thyroglossal duct cyst in the thyroid has also been described in the literature 27. Most of the mucin of these tumors are of intracellular location and a large amount of mucin can cause a signet-ring appearance in signet-ring cell adenoma of the thyroid gland 6,28–31. The presence of mucosubstances in the normal thyroid gland is well known because the complex carbohydrate type of mucosubstances is essential for thyroglobulin metabolism.…”

Section: Discussionmentioning

confidence: 99%

“…27 Most of the mucin of these tumors are of intracellular location and a large amount of mucin can cause a signet-ring appearance in signet-ring cell adenoma of the thyroid gland. 6,[28][29][30][31] The presence of mucosubstances in the normal thyroid gland is well known because the complex carbohydrate type of mucosubstances is essential for thyroglobulin metabolism. As a result, one of the possible pathogeneses of the mucin-materials present in a thyroid neoplasm is due to protein-degradation of thyroglobulin, suggesting that the mucin is originally produced in follicular cells.…”

Section: Discussionmentioning

confidence: 99%

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Follicular Adenoma with Extensive Extracellular Mucin Deposition: Report on Two Cases

Kim

Cho

Piña‐Oviedo

et al. 2012

Clin Med Insights Case Rep

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We report two cases of follicular adenoma of the thyroid with extensive extracellular mucin deposition. Fine needle aspiration in Case 1 showed singly discohesive polygonal cells in a granular mucinous background. They contained abundant eosinophilic cytoplasm, nuclear irregularities, and frequent nuclear inclusions with occasional bizarre mitoses. A right lobectomy was done. In Case 2, a 47-year-old Caucasian woman with multinodular goiter had total thyroidectomy and a yellow-tan nodule was found within the right lobe. Both tumors were well-encapsulated masses with thick capsules. Each was characterized by microfollicles without papillae in a mucinous stroma. Tumor cells were positive for thyroglobulin and negative for calcitonin, CEA, galectin-3, HBME-1, and CK19. The extracellular mucin stained with Alcian-blue and colloidal iron but not with mucicarmine and D-PAS. No BRAF gene mutation was detected. Because there were neither capsular nor vascular invasions, both cases were diagnosed as follicular adenomas of the thyroid with extensive extracellular mucin deposition, which as proposed by the WHO classification can be categorized as a mucinous variant of follicular adenoma. Retrospectively, frequent nuclear inclusions and the absence of nuclear grooves in the mucin-containing background of cytologic smears and histologic sections were shared by those of mucin-producing papillary carcinoma. It is unclear whether it belongs to an existing category of thyroid neoplasm with mucin production or whether it is truly a new tumor variant. Furthermore, pathologists should pay attention to avoid misdiagnosis of this variant of follicular neoplasm that shows an overlapping cytology with that of papillary carcinoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Follicular Adenoma with Extensive Extracellular Mucin Deposition: Report on Two Cases

Kim

Cho

Piña‐Oviedo

et al. 2012

Clin Med Insights Case Rep

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“…Follicular cells in the thyroid tissue may undergo squamous, oncocytic, or clear cell metaplasia. Of these, the clear cell change with signet ring is the least common variant [ 9 , 10 ]. The thyroid signet ring cell (SRC) variant refers to the intracytosolic accumulation of thyroglobulin (TG) [ 11 ], mucin [ 11 – 13 ], lipids [ 11 , 13 ], glycogen [ 11 ], inclusions [ 14 ], lipofuscin, hemosiderin [ 13 ], and other substances [ 15 ] in thyrocytes.…”

Section: Introductionmentioning

confidence: 99%

“…This is consistent with the reported results of several other studies [ 10 , 11 , 15 , 18 ]. However, mucin enrichment, dysfunctional swollen endoplasmic reticulum or Golgi apparatus [ 9 ], and degenerate mitochondria [ 15 ] could also lead to the nuclei being pushed to the side of the cell. In our case, we could not definitively conclude whether these causes were associated with our results in the absence of further testing.…”

Section: Introductionmentioning

confidence: 99%

Congenital goiter with areas of signet ring cell differentiation in a juvenile giraffe: a very rare entity

et al. 2020

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Background Congenital goiter is a common thyroid metabolic disorder characterized by low levels of thyroid hormone, subsequent secretion of excess thyroid-stimulating hormone (TSH) from the pituitary gland, and compensatory hyperplasia of the glands. The presence of signet ring cells (SRCs) does not provide sufficient evidence for the diagnosis of a thyroid tumor, making histopathological diagnosis challenging. In addition, SRCs can also appear in congenital goiter. Therefore, a comprehensive diagnosis of congenital goiter is warranted based on clinical symptoms, autopsy, histopathology, and laboratory examination. Case presentation A juvenile giraffe at the Ordos Zoo in Ordos presented with symptoms of loss of appetite, serious salivation, and slow growth rate since birth. Its height and weight were significantly lower than those of other giraffes of the same age. The animal ultimately died at 17 months of age. Autopsy revelaed that the thyroids were hard, with an uneven surface and with the presence of many small raised follicles, and dense in cross-section. Other organs were visibly atrophic. Histopathologically, diffuse follicles were irregular in size and shape in the hyperplastic goiter. Some follicles were collapsed due to lack of colloids. The follicles were lined by single or multiple layers of hyperplastic follicular cells (HFCs), some of which were exfoliated in the lumen. The HFCs were either cuboidal with eosinophilic cytoplasm and many red small granules or showed SRC differentiation, with nuclei pressed to one edge of the cell and distorted by cytoplasmic mucin that appeared as a single clear vacuole HFCs and as a foamy, multivesicular cytoplasmic material in others. Scattered necrosis of myocardial cells and hepatocytes, cerebral hemorrhage, necrosis of intestinal villi, and obvious atrophy of organs were also observed. Immunohistochemical tests were strongly positive for thyroglobulin and thyroid transcription factor-1 (TTF-1) in the cytoplasm of HFCs. Conclusions Here we present a case of congenital goiter with areas of SRC differentiation in the thyroid of a juvenile giraffe.

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“…Clear cells in benign thyroid neoplasms can take two main forms namely: balloon cells [10] and signet-ring cells [11,12]. Balloon cells are large swollen cells with clear foamy or finely granular cytoplasm.…”

Section:  Introductionmentioning

confidence: 99%

Clear cell change in follicular adenoma of the thyroid. A diagnostic challenge

Val‐Bernal

Martino²

2020

Rom J Morphol Embryol

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Clear cells in thyroid neoplasms can take two main forms: balloon-shaped and signet-ring cells. Balloon-shaped cell change in follicular adenoma is rare. A review of the literature has revealed only 20 previously published cases. We report herein a new case in the right thyroid lobe of a 45-year-old man. The clinicopathological data of the 21 cases including our paper have revealed that the ages of the patients ranged from 22-70 years, with a mean of 41.6 years. There was a clear predominance in women (M:F, 1:6). The most frequent location was in either of both lobes (81.8%), rarely affecting the isthmus. One case was observed in an ectopic thyroid in the submandibular region. The size ranged from 0.7-5.5 cm (mean 2.9 cm). The type of surgical intervention where this data was reported it was lobectomy for 10 (55.5%) cases, thyroidectomy for six (33.3%) cases, and simple excision for two (11.1%) cases. In one patient, the lobectomy was accompanied by cervical lymph node dissection. No cases recurred or extended outside the thyroid. The main differential diagnoses include intrathyroidal clear cell tumor of parathyroid origin, clear cell carcinoma of follicular, oncocytic, papillary, medullary or undifferentiated (anaplastic) origin, paraganglioma, metastatic clear cell carcinoma, especially of renal origin, metastatic balloon cell melanoma, and clear large-cell lymphoma. A thyroid lesion showing clear cell change constitutes a diagnostic challenge in cytological and biopsy diagnosis. Careful observation of the routine techniques along with the aid of an adequate immunohistochemical panel is essential to reach a correct biopsy diagnosis.

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Signet Ring Cell Adenoma of the Thyroid: A Very Rare Entity

Cited by 7 publications

References 12 publications

Follicular Adenoma with Extensive Extracellular Mucin Deposition: Report on Two Cases

Follicular Adenoma with Extensive Extracellular Mucin Deposition: Report on Two Cases

Congenital goiter with areas of signet ring cell differentiation in a juvenile giraffe: a very rare entity

Clear cell change in follicular adenoma of the thyroid. A diagnostic challenge

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