Thyroid Adenoma with Extensive Extracellular Mucin Deposition: Report of a Case

Murakami, Saburo; Sakata, Hideto; Okubo, Kyohei; Tsuji, Yoshitaka; Kayano, Hidekazu

doi:10.1007/s00595-006-3388-1

Cited by 9 publications

(13 citation statements)

References 32 publications

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“…The case reports of mucinous thyroid tumors [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27], including the current three cases, are summarized in table 2. The list does not include the mucin-negative signet ring thyroid tumors described by Schröder and Böcker [28] and commented on by LiVolsi [29].…”

Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration of Mucin-Producing Thyroid Tumors

Yang¹,

Scognamiglio²,

Kuhel

2011

Acta Cytologica

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Objective: Mucin-producing thyroid tumors are extremely rare. Nonetheless, we have encountered three such cases in fine-needle aspiration. We report the cytologic and histologic findings and review the literature. Study Design: Cytologic features were studied on direct smears using Romanovsky stain to detect background substance and Papanicolaou stain to analyze nuclear and cytoplasmic features. The cytologic features were correlated with histology. Mucin was demonstrated by mucicarmine, Alcian Blue/PAS, and Alcian Blue (pH 2.5). Results: The cytologic features related to mucin include: (1) thick luminal mucin globules and signet ring cells aspirated from an 83-year-old woman with a 3-cm signet ring cell follicular adenoma, (2) abundant fluffy mucin containing signet ring cells in cohesive fragments aspirated from a 75-year-old man with the bilateral signet ring cell follicular variant of papillary carcinoma, which is the first case in the English literature, and (3) abundant thin mucoid mucin aspirated from the lymph node of an 86-year-old woman with a 5-cm mucinous poorly differentiated thyroid carcinoma. Conclusion: The occurrence of mucin in thyroid fine-needle aspiration does not necessarily indicate metastasis, and the presence of mucin in cervical lymph nodes does not exclude the thyroid gland as a possible primary.

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Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration of Mucin-Producing Thyroid Tumors

Yang¹,

Scognamiglio²,

Kuhel

2011

Acta Cytologica

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“…24 Mucin can be seen in a wide spectrum of primary thyroid tumors including follicular neoplasms, medullary carcinoma, poorly differentiated carcinoma, papillary and undifferentiated carcinomas, and mucoepidermoid and primary mucinous carcinomas. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]19,25,26 A mucincontaining 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.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Several cases of stromal mucin-producing thyroid neoplasms have also been reported. [8][9][10][11][12][13][14][15][16] We report here on two additional cases of follicular adenoma with thick capsule and extensive stromal mucin deposits. Importantly, this is the first time that BRAF gene mutation analysis is performed in these types of lesions.…”

Section: Introductionmentioning

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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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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“…They also stated that immunohistochemical staining for thyroglobulin is a useful marker in discriminating signet ring cell adenomas from metastatic signet ring cell carcinomas [6] . Murakami et al [7] reported an unusual case of thyroid adenoma with extensive mucin deposition in the extracellular space. This unusual finding is also termed extensive myxoid stroma, and is thought to be associated with differentiation of thyroid follicular cells into mucin-producing cells [7] .…”

Section: Discussionmentioning

confidence: 99%

“…Murakami et al [7] reported an unusual case of thyroid adenoma with extensive mucin deposition in the extracellular space. This unusual finding is also termed extensive myxoid stroma, and is thought to be associated with differentiation of thyroid follicular cells into mucin-producing cells [7] . Patients with neck masses may present with symptoms including dysphagia, dyspnea, and chronic neck pain.…”

Section: Discussionmentioning

confidence: 99%

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

Yalta¹,

Elagöz

Uyar³

et al. 2009

Med Princ Pract

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Objectives: To report a case of signet ring cell adenoma of the thyroid which is an extremely rare thyroid lesion. Clinical Presentation and Intervention: A 25-year-old female patient presented with a goiter and dysphagia that had been present for the last 1 year before admission. Physical examination revealed a palpable solitary nodule in the right lobe of the thyroid. The ultrasonogram demonstrated multiple nodules among which the most remarkable one was 15 × 24 mm in size, in the right lobe of the thyroid. After surgical excision, the lesion was found to be consistent withsignet ring cell adenomacharacterized by the presence of round to oval signet ring cells with large cytoplasmic vacuoles and hyperchromatic eccentric nuclei. Intracytoplasmic thyroglobulin, periodic acid-Schiff (PAS) with and without diastase and combined Alcian-blue-PAS were all positive. Conclusions: Pathologists should keep this rare primary tumor of the thyroid in mind when examining thyroid lesions and should not confound it with metastatic signet ring cell carcinoma of the thyroid.

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Thyroid Adenoma with Extensive Extracellular Mucin Deposition: Report of a Case

Cited by 9 publications

References 32 publications

Fine-Needle Aspiration of Mucin-Producing Thyroid Tumors

Fine-Needle Aspiration of Mucin-Producing Thyroid Tumors

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

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

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