Immunohistochemical Analysis of Insular Carcinoma of the Thyroid Gland
민혜숙, 정두현, 이경분, 박성호, 백진호,
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민혜숙 ( Min Hye-Sook )
서울대학교 의과대학 병리학교실
정두현 ( Chung Doo-Hyun )
서울대학교 의과대학 병리학교실
이경분 ( Lee Kyoung-Bun )
서울대학교 의과대학 병리학교실
박성호 ( Park Seong-Hoe )
서울대학교 의과대학 병리학교실
백진호 ( Paik Jin-Ho )
서울대학교 의과대학 병리학교실
KMID : 0357920050390050326
Abstract
Background: Insular thyroid carcinoma (ITC) is a relatively infrequent thyroid carcinoma that has distinctive histologic features. ITC shows an aggressive clinical course and the predominant presence of an insular component, which has been reported to be an independent factor of a poor prognosis. We retrospectively examined clinical details of the nine ITC patients, which represented 9 years of experience with ITC, and investigated the expressions of variable neuroendocrine and other immunohistochemical markers associated with well-differentiated thyroid carcinomas.
Methods: We adopted an immunohistochemical approach and studied the expressions of synaptophysin, chromogranin A, CD56, NSE, S-100, RET, PPAR , calcitonin, galectin-3, and thyroglobulin in formalin-fixed, paraffin embedded tissue array slides of the 9 ITC patients, and investigated clinical features. Seven cases of follicular carcinoma and 4 cases of medullary carcinoma were also included as controls.
Results: ITCs were positive for synaptophysin (44%, 4/9), CD56 (11%, 1/9), NSE (89%, 8/9), S100 (67%, 6/9), calcitonin (22%, 2/9), galectin-3 (78%, 7/9), and thyroglobulin (100%, 9/9), but completely negative for chromogranin A, RET, and PPAR .
Conclusion: ITCs express neuroendocrine markers in variable proportions and appear not to be associated with the oncoproteins of conventional thyroid carcinomas. Notably, its differential diagnosis from medullary carcinoma is required in cases showing focal calcitonin positivity.
키워드
Insular carcinoma;Thyroid gland;Neuroendocrine markers
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