Progression of Papillary Thyroid Carcinoma to Anaplastic Carcinoma in Metastatic Lymph Nodes: Solid/Insular Growth and Hobnail Cell Change in Lymph Nodes Are Predictors of Subsequent Anaplastic Transformation

التفاصيل البيبلوغرافية
العنوان: Progression of Papillary Thyroid Carcinoma to Anaplastic Carcinoma in Metastatic Lymph Nodes: Solid/Insular Growth and Hobnail Cell Change in Lymph Nodes Are Predictors of Subsequent Anaplastic Transformation
المؤلفون: Junko Akaishi, Naoki Oishi, Toru Odate, Koichi Ito, Masataka Kawai, Ryohei Katoh, Ippei Tahara, Kunio Mochizuki, Tetsuo Kondo
المصدر: Endocrine Pathology
بيانات النشر: Springer Science and Business Media LLC, 2021.
سنة النشر: 2021
مصطلحات موضوعية: Adult, Male, TERT, Endocrinology, Diabetes and Metabolism, Cell, Article, BRAF, Pathology and Forensic Medicine, Thyroid carcinoma, Endocrinology, medicine, Humans, Thyroid Neoplasms, Anaplastic carcinoma, Telomerase, Lymph node, Aged, business.industry, Carcinoma, Thyroid, Anaplastic thyroid carcinoma, General Medicine, Middle Aged, medicine.disease, Primary tumor, Cell Transformation, Neoplastic, medicine.anatomical_structure, Thyroid Cancer, Papillary, Lymphatic Metastasis, Papillary thyroid carcinoma, Mutation, Disease Progression, Anaplastic transformation, Cancer research, Female, Lymph, business, NODAL
الوصف: Most anaplastic thyroid carcinomas (ATCs) arise from papillary thyroid carcinoma (PTC). This process is also called anaplastic transformation, and the morphological harbingers of this phenomenon in nodal recurrence have not been assessed systematically. For this reason, the current study focused on features of 10 PTCs with regional lymph node recurrence that was accompanied with disease progression due to anaplastic transformation in at least one of the nodal recurrences. The findings of additional 19 PTCs which recurred without anaplastic transformation after ≥ 10 years of follow-up served as the control group. There were no clinicopathological differences between the two groups at initial surgery including age, gender, tumor size, lymph node metastasis, distant metastasis, extrathyroidal extension, histologic subtype, and treatment. The median time from the initial thyroid surgery to anaplastic transformation in the nodal recurrence was 106 months (range 6 to 437 months). Mutational analyses showed recurrent PTCs with anaplastic transformation had a high prevalence of BRAFV600E mutation (8/9) and TERT promoter mutation (9/9), both of which were detected in primary tumors. PIK3CAH1047R mutation was detected in one case. No case had RAS mutation. Nineteen recurrent PTCs without anaplastic transformation harbored BRAFV600E mutation and seventeen of these had TERT promoter mutation. Unlike primary tumors with subsequent nodal anaplastic transformation, TERT promoter mutation was only present in the metastatic nodal recurrence from 4 patients without transformation. No patients had neither high-grade features (necrosis and increased mitotic activity) nor solid/insular growth or hobnail cell features in their primary tumors. In the group of patients with transformation, 3 had solid/insular growth in the lymph node metastasis at the time of primary tumor resection (one displaying nuclear features of PTC and solid growth with increased mitotic activity, one with insular component consistent with poorly differentiated carcinoma component, and one displaying nuclear features of PTC and solid growth), and additional 2 patients had solid/insular growth with no high-grade features or poorly differentiated carcinoma component at the time of subsequent nodal recurrence prior to anaplastic transformation. Hobnail cell features were exclusively seen in subsequent metastatic lymph nodes prior to anaplastic transformation. The control group lacked solid/insular growth and hobnail cell features in the metastatic nodal disease. Aberrant p53 expression and loss of TTF-1 featured tumor components with anaplastic transformation. This series identified a subset of recurrent PTCs with TERT promoter mutation was prone to undergo anaplastic transformation, and that solid/insular growth and hobnail cell features were morphological predictors of anaplastic transformation in the nodal recurrence.
تدمد: 1559-0097
1046-3976
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::59217c3f28c0c6571742209224b58ca6
https://doi.org/10.1007/s12022-021-09674-1
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....59217c3f28c0c6571742209224b58ca6
قاعدة البيانات: OpenAIRE