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      Hyalinizing trabecular tumor of the thyroid gland

      case-report

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          Abstract

          Hyalinizing trabecular tumor (HTT) is an unusual and controversial lesion of the thyroid gland. Some have considered it a unique entity, some have considered it a variant of papillary carcinoma, and still others have considered it a nonspecific pattern that may be seen with a variety of thyroid lesions. The histological and ultrastructural characteristics of this thyroid neoplasm are well documented; however, its cytological diagnosis by fine needle aspiration cytology (FNAC) remains challenging. The cytomorphological features of this entity overlap with both papillary and medullary carcinoma to a varying extent. We report a case of HTT with cytological evaluation by FNAC in a 28-year-old male.

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          Hyalinizing trabecular adenoma of the thyroid gland.

          Thomas Carney, J Goellner, Jim Ryan (1987)
          The hyalinizing trabecular adenoma, a distinctive lesion, is important because it may mimic medullary and papillary carcinoma microscopically. We describe 11 such tumors obtained from women ages 27-72 years (mean, 46 years). The initial pathologic diagnoses were carcinoma (five cases), adenoma (two cases), paraganglioma (one case), and "indeterminate" (three cases). None of the tumors recurred or metastasized (mean follow-up, 10 years). Grossly, the neoplasms measured 0.3-4 cm in diameter, and were yellow-tan and circumscribed. Microscopically, they were encapsulated or circumscribed and solid, or vaguely lobulated. The polygonal, oval, and elongated tumor cells were arranged in trabeculae, clusters, or both, and were often inserted vertically into capillaries. The sharply outlined cells had finely granular cytoplasm that was either acidophilic, amphophilic, or clear. Typical features included oval and elongated nuclei, perinucleolar vacuoles, acidophilic nuclear inclusions, fine nuclear grooving, and infrequent mitotic figures. Perivascular hyaline fibrosis and cell degeneration mimicked amyloid, but these tumors were Congo red-negative. Occasional trabeculae featured round or irregularly shaped follicles, sometimes with papillary infoldings, that were either empty or contained colloid-like material and psammoma bodies. Immunostaining of tumor cells was positive for thyroglobulin and negative for calcitonin. Among six tumors analyzed by flow cytometry, five displayed a diploid pattern and one showed an aneuploid peak.
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            RET/PTC activation in hyalinizing trabecular tumors of the thyroid.

            A Fassina, Alfredo Fusco, M Papotti … (2000)
            Hyalinizing trabecular tumor (HTT) of the thyroid is a neoplasm of follicular derivation with a histogenesis that is still the subject of debate. Morphologic affinities between HTT and papillary carcinoma, including nuclear pseudoinclusions and grooves, suggest that these tumors may be of similar origin. The authors investigated the relationship between these two types of tumors by assessing HTT for the presence of rearrangements of the proto-oncogene rearranged during transfection (RET) that, in thyroid tumors, are specific for papillary carcinoma. A series of 14 HTTs, including two cases associated with classic papillary carcinoma, was studied by means of immunohistochemistry and reverse transcription-polymerase chain reaction. Seven follicular adenomas with focal hyalinized trabecular areas served as control cases. Three of the 14 HTT cases under consideration displayed rearrangements of RET generating the RET/papillary thyroid carcinoma type 1 (PTC1) oncogene. In another case, RET expression was detected focally by immunohistochemistry alone. Finally, in one mixed HTT-papillary carcinoma sample, RET/PTC1 expression was detected, but only in the papillary component. None of the control follicular adenomas contained rearrangements of RET/PTC. These findings demonstrate that a comparable percentage (28.6%) of HTTs and papillary carcinomas exhibit the same RET proto-oncogene alterations. Thus, HTT may represent the "hyalinizing trabecular" variant of papillary carcinoma rather than a separate entity.
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              Cell membrane and cytoplasmic staining for MIB-1 in hyalinizing trabecular adenoma of the thyroid gland.

              M Hirokawa, Thomas Carney (2000)
              The monoclonal MIB-1 antibody reacts with the nuclei of cells in the late G1, S, G2, and M phases of the cell cycle. Previously, we found two cases of hyalinizing trabecular adenoma that showed cell membrane and cytoplasmic immunopositivity for the antibody. The purpose of this investigation was to confirm this exceptional reactive pattern of MIB-1 in hyalinizing trabecular adenoma. For the study, we collected 13 additional hyalinizing trabecular adenomas and stained a total of 15 tumors using MIB-1 antibody. Ten cases of papillary thyroid carcinoma were studied similarly. All hyalinizing trabecular adenomas showed strong positivity for the antibody in 90% or more of the tumor cells, localized especially to the cell membrane and also to the cytoplasm. There was no cell membrane or cytoplasmic MIB-1 positivity among the 10 papillary carcinomas. Luminal border of normal extratumoral thyroid follicles rarely showed faint immunopositivity. Our findings indicate that strong cell membrane and cytoplasmic immunoreactivity for MIB-1 is a characteristic of the hyalinizing trabecular adenoma. Staining for MIB-1 will be useful in differentiating hyalinizing trabecular adenoma from papillary carcinoma, which shares a number of cytologic and histologic findings with hyalinizing trabecular adenoma.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cytol
                Journal ID (publisher-id): JCytol
                Title: Journal of Cytology / Indian Academy of Cytologists
                Publisher: Medknow Publications (India )
                ISSN (Print): 0970-9371
                ISSN (Electronic): 0974-5165
                Publication date (Print): April 2010
                Volume: 27
                Issue: 2
                Pages: 63-65
                Affiliations
                Department of Pathology, Pt. B.D. Sharma PGIMS, Rohtak, India
                Author notes
                Address for correspondence: Dr. Sumiti Gupta, 1037/24, Jagdish Colony, Rohtak - 124 001, India. E-mail: drsumitigupta@ 123456yahoo.in
                Article
                Publisher ID: JCytol-27-63
                DOI: 10.4103/0970-9371.70741
                PMC ID: 3001178
                PubMed ID: 21157552
                SO-VID: 2f430820-1cf9-4915-8114-4cf965ed4c0a
                Copyright © © Journal of Cytology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Pathology
                Keywords: hyalinizing trabecular tumor,fine needle aspiration cytology,thyroid
                Data availability:
                ScienceOpen disciplines: Pathology
                Keywords: hyalinizing trabecular tumor, fine needle aspiration cytology, thyroid

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