Sonographic Findings of the Diffuse Sclerosing Variant of Papillary Carcinoma of the Thyroid

Zhang, Yuhong; Dao-zi, Xia; Lin, Ping; Lin, Gen‐Min; Li, Guangsen; Zhang, Wenhua

doi:10.7863/jum.2010.29.8.1223

Cited by 29 publications

(30 citation statements)

References 8 publications

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“…In ultrasonography, hyper-echogenicity, diffuse scattered micro-calcification and cervical lymph node metastasis were the characteristic features in DSVPTC [28]. The calcification and extent of the disease can also be detected by specimen radiography [44,45].…”

Section: Pre-operative Diagnosismentioning

confidence: 97%

See 1 more Smart Citation

Diffuse sclerosing variant of papillary thyroid carcinoma—an update of its clinicopathological features and molecular biology

Pillai

Gopalan

Smith

et al. 2015

Critical Reviews in Oncology/Hematology

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Diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC) is an uncommon variant of papillary thyroid carcinoma. The aim of this review is to critically analyse the features of this entity. A search of the literature revealed 25 clinicopathological studies with in-depth analysis of features of DSVPTC. Overall, the prevalence of DSVPTC varies from 0.7-6.6% of all papillary thyroid carcinoma. Higher prevalence of DSVPTC was noted in paediatric patients and in patients affected by irradiation. DSVPTC tends to occur more frequently in women and in patients in the third decade of life. Macroscopically, DSVPTC can involve the thyroid gland extensively without forming a dominant mass. Microscopic examination of DSVPTC revealed extensive fibrosis, squamous metaplasia and numerous psammoma bodies. The latter pathological feature can aid in the pre-operative diagnosis of the entity by fine needle aspiration and ultrasound. Compared to conventional papillary thyroid carcinoma, DSVPTC had a higher incidence of lymph node metastases at presentation. Distant metastases were noted in approximately 5% of the cases. Patients with DSVPTC were recommended to be managed by aggressive treatment protocols. It is likely that as a result of this, the prognosis of the patients with DSVPTC was noted to be similar to conventional papillary thyroid carcinoma. Overall, cancer recurrence and cancer related mortality have been reported in 14% and 3%, respectively, of patients with DSVPTC. In immunohistochemical studies, DSVPTC showed different expression patterns of epithelial membrane antigen, galectin 3, cell adhesion molecules, p53 and p63 when compared to conventional papillary thyroid carcinoma. On genetic analysis, the occurrence of BRAF and RAS mutations are uncommon events in DSVPTC and activation of RET/PTC rearrangements are common. To conclude, DSVPTC has different clinical, pathological and molecular profiles when compared to conventional papillary thyroid carcinoma.

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Section: Pre-operative Diagnosismentioning

confidence: 97%

“…In addition, vascular invasion by tumour cells may be seen [17]. Furthermore, presence of calcification/ossification in the stroma of thyroid carcinomas could be a feature of aggressive thyroid carcinomas [28]. Lam and Lo reported the presence of osseous metaplasia in a patient with DSVPTC, who eventually died of the disease [18].…”

Section: Microscopic Featuresmentioning

confidence: 97%

Diffuse sclerosing variant of papillary thyroid carcinoma—an update of its clinicopathological features and molecular biology

Pillai

Gopalan

Smith

et al. 2015

Critical Reviews in Oncology/Hematology

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“…Several studies have focused on the potential of identifying DSV preoperatively, thus allowing better operative planning. In a study of eight patients with pathologically documented DSV, Zhang et al [11] retrospectively analyzed the thyroid ultrasound examinations of these patients. All eight cases displayed diffuse involvement of the ipsilateral thyroid lobe; 63% of cases showed hyperechogenicity; 88% had diffuse scattered microcalcifications; and all cases showed cervical metastatic lymph nodes.…”

Section: Preoperative Diagnosismentioning

confidence: 99%

Aggressive variants of papillary thyroid cancer

Roman

Sosa

2013

Current Opinion in Oncology

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“…The preliminary ultrasonic diagnostic impression was of Hashimoto's thyroiditis. It is well known that microcalcifications within a solitary thyroid mass on sonography are generally regarded as the most reliable indicators of malignancy (17). Since the present case showed diffuse scattered microcalcifications, it is imperative to accurately identify the underlying papillary carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Shear wave elastography diagnosis of the diffuse sclerosing variant of papillary thyroid carcinoma: A case report

Xue

Huang

et al. 2016

Molecular and Clinical Oncology

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Abstract. The present study aimed to report the shear wave elastography (SWE) findings in a patient with the diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC). Since patients with DSVPTC may present with typical clinicopathological features and initially appear to have Hashimoto's thyroiditis, a thorough clinical evaluation and an early diagnosis are important. A 20-year-old female patient presented with a 1-month history of a neck mass and sore throat. Conventional ultrasound and SWE were performed using an AIXPLORER system with 14-5 MHz linear transducer. The patient had undergone total thyroidectomy and bilateral neck lymph node dissection, and an intraoperative pathology consultation to confirm the malignancy of lymph node metastasis. Pathological diagnosis was DSVPTC in both lobes, with lymph node metastases in the bilateral neck. The clinical presentation and serological findings were all indicative of Hashimoto's thyroiditis. Thyroid ultrasonography revealed diffuse enlargement of the both lobes, heterogenous echogenicity without mass formation, diffuse scattered microcalcifications and poor vascularization. SWE revealed stiff values of the thyroid: The mean stiffness was 99.7 kpa, the minimum stiffness was 59.1 kpa and the maximum stiffness was 180.1 kpa. The maximum stiffness of the DSVPTC (180.1 kpa) was higher compared with the diagnostic criteria of malignant thyroid nodules (65 kPa). SWE may be considered as a novel and valuable method to diagnose DSVPC.

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Sonographic Findings of the Diffuse Sclerosing Variant of Papillary Carcinoma of the Thyroid

Abstract: The sonographic findings of DSVPC of the thyroid are characteristic, and sonography is a useful imaging tool in diagnosis of DSVPC of the thyroid.

Cited by 29 publications

References 8 publications

Diffuse sclerosing variant of papillary thyroid carcinoma—an update of its clinicopathological features and molecular biology

Diffuse sclerosing variant of papillary thyroid carcinoma—an update of its clinicopathological features and molecular biology

Aggressive variants of papillary thyroid cancer

Shear wave elastography diagnosis of the diffuse sclerosing variant of papillary thyroid carcinoma: A case report

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