유방의 양성 및 악성 유두상 종양의 세포학적 소견의 비교 검색

이호정,공경엽,김봉희,안세현,박정미,허주령,강신광,노재윤,Lee, Ho-Jung,Gong, Gyung-Yub,Kim, Bohng-Hee,Ahn, Sei-Hyun,Park, Jeoug-Mi,Huh, Joo-Ryung,Khang, Shin-Kwang,Ro, Jae-Y. 대한세포병리학회 1999 대한세포병리학회지 Vol.10 No.1

Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carcinomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. Ail cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papillomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(57%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases on papillary lesions of the breast to further characterize the tumor.

Correlation of Expression of p53, Cylcin D1 and Galectin-3 in Papillary Carcinoma and Follicular Carcinoma

Back, Oun-Cheol 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.1

The thyroid is the organ that has the greatest risk of malignant tumors among the endocrine tumors. The papillary carcinoma occupies 80% of the entire thyroid tumors. Immunohistochemical staining of galectin-3 has usually been used in differentiating papillary carcinoma and follicular carcinoma. The p53 gene of the cell cycle is a tumor suppressor gene acting in on the control points. The cyclin D1 genes in the cell cycle, involved in the implementation of G1 and S phase, plays an important role in the progression of thyroid tumors. This research compares and analyzes correlation between papillary carcinoma, follicular carcinoma, p53, cyclin D1 and galectin-3 gene expression patterns. In a total of 30 cases from papillary carcinoma, 21 cases from p53 (70%), 27 cases in galectin-3 (90%), and 26 cases in cyclin D1 (86.7%) showed positive rate. The galectin-3 staining investigated, showed a significant difference between a papillary carcinoma and a follicular carcinoma. Follicular carcinoma from 15 cases, p53 in 13 cases (86.7%), galectin-3 in 5 cases (33.3%) and cyclin D1 in 12 cases (80%) showed a positive rate. The cyclin D1 in follicular carcinoma and staining between the p53 that had correlation was also investigated. In this study, as the examples of the expression of the 27 cases of galectin-3 (90%) in papillary carcinoma and 5 cases in follicular carcinoma (33.3%) indicate, it was concluded that there is a difference in the expression on both carcinoma. In addition, cyclin D1 and p53 has a positive rate in follicular carcinoma, when cyclin D1 in 12 cases (80%), there was a significant correlation that was investigated. Distinguishing between papillary carcinoma and follicular carcinoma can be identified by the expression of galectin-3. It is considered to get results that are more accurate in follicular carcinoma diagnosis depending on whether the cyclin D1 and p53 is expressed or not.

유두암과 여포 암에서 p53, Cylcin D1, Galectin-3 발현의 상관 관계

백운철 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.1

The thyroid is the organ that has the greatest risk of malignant tumors among the endocrine tumors. The papillary carcinoma occupies 80% of the entire thyroid tumors. Immunohistochemical staining of galectin-3 has usually been used in differentiating papillary carcinoma and follicular carcinoma. The p53 gene of the cell cycle is a tumor suppressor gene acting in on the control points. The cyclin D1 genes in the cell cycle, involved in the implementation of G1 and S phase, plays an important role in the progression of thyroid tumors. This research compares and analyzes correlation between papillary carcinoma, follicular carcinoma, p53, cyclin D1 and galectin-3 gene expression patterns. In a total of 30 cases from papillary carcinoma, 21 cases from p53 (70%), 27 cases in galectin-3 (90%), and 26 cases in cyclin D1 (86.7%) showed positive rate. The galectin-3 staining investigated, showed a significant difference between a papillary carcinoma and a follicular carcinoma. Follicular carcinoma from 15 cases, p53 in 13 cases (86.7%), galectin-3 in 5 cases (33.3%) and cyclin D1 in 12 cases (80%) showed a positive rate. The cyclin D1 in follicular carcinoma and staining between the p53 that had correlation was also investigated. In this study, as the examples of the expression of the 27 cases of galectin-3 (90%) in papillary carcinoma and 5 cases in follicular carcinoma (33.3%) indicate, it was concluded that there is a difference in the expression on both carcinoma. In addition, cyclin D1 and p53 has a positive rate in follicular carcinoma, when cyclin D1 in 12 cases (80%), there was a significant correlation that was investigated. Distinguishing between papillary carcinoma and follicular carcinoma can be identified by the expression of galectin-3. It is considered to get results that are more accurate in follicular carcinoma diagnosis depending on whether the cyclin D1 and p53 is expressed or not.

갑상선 유두상 암종과 유두상 증식에 대한 S-100 단백 및 EMA 발현에 대한 연구

강대영,김경희,최정목,송규상,강동욱 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The diagnosis of papillary carcinoma of the thyroid is readily achieved based on a defined aggregate of histopathologic features. A papillary architecture is an imporant but not pivotal component of the diagnosis. The classic nuclear features are the essential diagnostic element. However, both papillary architecture and nuclear features may be encountered in other conditions and produce problems in histopahologic interpretation. A papillary architecture may be found within a follicular or an oncocytic neoplasm of within the nodules of hyperplastic nodular goiter. Moreover, there may be scattered cells within several thyroid lesions that display some of the nuclear characteristics of papillary carcinoma. The distinction of these lesions from papillary carcinoma is important for differential diagnosis. Thus, the availability of supportive diagnosic evidence would be helpful. Immunoreactivity for S-100 and epithelial membrace antigen was investigated in 16 papillary thyroid carcinomas(PTC), including three examples of the follicular variant, 16 cases of papillary hyperplasis, 8 follicular adenomas, and 6 follicular carcinomas. The degree of reaction was rated on a four point scale: +++, most cells(>51%) have positive staining; ++, 11-50% of cells have positive staining; +, less than 10% of cells have positive staining; -, no positive staining is present. The results are summarized as follows: 1) All the papillary carcinomas showed intense nuclear and cytoplasmic expression of S-100 (+++; 7 cases, ++; 9 cases), and EMA was expressed(++; 7 cases, ++; 6 cases, +; 3 cases). 2) In the cases of papillary hperplasia, papillary foci were generally negative for S-100 and EMA(12/16 ; -). In some areas, they were focal, of weak intensity, and showed preferential apical cytoplasmic location of oncocytic change. 3) Four of eight follicular adenomas expressed S-100(++;2 cases, +; 2 cases), whereas four were completely negative. EMA was also expressed(++; 2 cases, +; 3 cases). 4) Follicular carcinoma showed variable expression of S100 and EMA Five of six follicular carcinomas expressed S-100(++; 2 cases, +; 3 cases), whereas one was negative. EMA was also expressed(++; 2 cases, +; 1 case). In conclusion, in the distinction of papilary carcinoma from papillary hyperplasia, we would recommend an initial histological appraisal, with immunohistochemical staining of S100 and EMA in difficult cases.

유두 갑상선암의 왈틴 양 변이의 임상병리적 특성

정종주,이용상,홍순원<SUP>1<,SUP>,강상욱,성태연,이승철,남기현,장항석,정웅윤,박정수,Jong Ju Jeong,M,D,Yong Sang Lee,M,D,Soon Won Hong,M,D,<SUP>1<,SUP>,Sang-Wook Kang,M,D,Tae Yon Sung,M,D,Seung Chul Lee,M,D,Kee-Hyun Nam,M,D,Hang-Seok 대한갑상선-내분비외과학회 2007 The Koreran journal of Endocrine Surgery Vol.7 No.4

Purpose: Warthin-like papillary carcinomawas named owing to its close histologic resemblance to a tumor encountered in salivary gland, and this tumor is a variant of papillary thyroid carcinoma. Among the variants of papillary thyroid carcinoma, the tall cell variant and diffuse sclerosing variant have more aggressive behavior than the classic papillary carcinoma. But Warthin-like papillary carcinoma arises in a background of thyroiditis and it behaves in an indolent fashion. Since then, a few case have reported in Korea. We report here on the clinicopathologic features of five cases of warthin-like papillary carcinoma. Methods: From Jan. 1996 to Feb. 2008, five patients who were diagnosed with Warthin-like papillary thyroid carcinoma at YUMC were retrospectively reviewed. Results: All 5 patients whose pathologic features were warthin-likepapillary thyroid carcinoma were women (age range: 34∼60 years). The tumor size ranged from 0.6 to 2.4 cm. 3 tumors were confined to the thyroid, but 2 tumors had invaded the strap muscles. 3 of the 5 tumors arose in a background of lymphocytic thyroditis. Central nodal metastases were identified in 2 cases. But no lateral nodal or distant metastasis had occurred. The mean duration of follow-up was 16.5 months (range: 5∼50 months). 1 patient died because of lung cancer, and there was no recurrence for the other 4 cases during the follow-up period. Conclusion: Although the long-term follow-up data on patients with Warthin-like papillary carcinoma is not available, the clinicopathologic data does not show that Warthin-like papillary carcinoma is any more aggressive than the usual papillary carcinoma. (Korean J Endocrine Surg 2007;7: 257-259)

Evaluating the Degree of Conformity of Papillary Carcinoma and Follicular Carcinoma to the Reported Ultrasonographic Findings of Malignant Thyroid Tumor

Jeh, Su-kyoung,Jung, So Lyung,Kim, Bum Soo,Lee, Yoen Soo unknown 2007 KOREAN JOURNAL OF RADIOLOGY Vol.8 No.3

<P><B>Objective</B></P><P>We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor.</P><P><B>Materials and Methods</B></P><P>Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and nonpalpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n = 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change.</P><P><B>Results</B></P><P>The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (<I>p</I> < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (<I>p</I> < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (<I>p</I> < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, <I>p</I> < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (<I>p</I> < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (<I>p</I> < 0.001).</P><P><B>Conclusion</B></P><P>The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for needle aspiration biopsy so that follicular carcinomas are not missed by too narrow and strict biopsy criteria.</P>

Silencing of homeobox B9 is associated with down-regulation of CD56 and extrathyroidal extension of tumor in papillary thyroid carcinoma

Kim, J.H.,Kim, Y.H.,Han, J.H.,Lee, K.B.,Sheen, S.S.,Lee, J.,Soh, E.Y.,Park, T.J. W. B. Saunders Co ; Centrum Philadelphia 2012 Human pathology Vol.43 No.8

Papillary thyroid carcinoma is the most common type of thyroid malignancy, and CD56, a neural cell adhesion molecule, is typically down-regulated in almost all cases of papillary thyroid carcinoma. Homeobox B9 is a transcription factor, belongs to the products of the homeobox transcription factor gene family, and has been known to regulate transcription of CD56 and to promote tumorigenicity and metastasis in some malignancies. In this study, we investigated the expression and relation of homeobox B9 to reduced expression of CD56 in papillary thyroid carcinomas and also a relationship between their expression and clinicopathologic parameters. Therefore, we performed CD56 and homeobox B9 immunohistochemical staining on 72 papillary thyroid carcinomas and Western blotting on 31 papillary thyroid carcinomas. CD56 protein staining revealed that it was reduced or absent in 65 papillary thyroid carcinomas (90.3%) and was related to silencing of homeobox B9 (77.8%) (P = .003). The loss of homeobox B9 expression was associated with extrathyroidal extension (P = .002), pathologic stage of tumor (P = .01), and age older than 45 years (P = .032). However, the CD56 staining did not reveal any significant relationship with clinicopathologic features (P > .05). In conclusion, reduced expression of CD56 is associated with homeobox B9 in papillary thyroid carcinomas. Furthermore, silencing of homeobox B9 is more common in older age and is linked to extrathyroidal extension and advanced pathologic stage of papillary thyroid carcinoma.

한국인 갑상선 질환의 병리학적 연구 : 1095 례의 외과적 절제물을 대상으로 Based on 1095 Surgically resected specimen

박성회,지제근,이현순,이정빈,안긍환,김용일,함의근,이상국 인제대학교 1983 仁濟醫學 Vol.4 No.4

A prospective morphological study was made on 1095 thyroid specimens which were removed surgically under various diagnoses at Seoul National University Hospital during a period of 6 years from 1976 to 1981. All thyroid specimens were carefully examined grossly by 3-5mm serial cutting after fixation. Almost entire thyroid specimen was submitted for microscopic examination. Therefore microscopic slides of one specimen ranged from 4 to 106 in number. Clinical records including operation notes were also referred to confirm the diagnosis. All of the material was examined and reviewed critically by the authors and was classified according to modified WHO classification. Among 1095 surgically removed thyroids, adenomatous goiter was the most common single disease which accounted for 43% of the entire cases. It was followed by papillary carcinoma and follicular adenoma. Of the malignant tumors, papillary carcinoma was the most frequently reported tumor, accounting for 259 cases (76%) of the entire malignancy. There were also 57 follicular carcinomas, 13 anaplastic carcinomas and 7 medullary carcinomas. Characteristic ground glass nuclei and psammoma bodies were seen fairly frequently showing the incidence of 64% and 65% of papillary carcinoma respectively. However, squamous metaplasia was present in only 17% of the papillary carcinoma. There were 56 occult sclerosing carcinomas. Most of these were detected in the thyroids of adenomatous goiter. The occult sclerosing carcinoma was found in 9.2% of adenomatous goiters while it was found in only 4.3% of follicular adenomas. It was interesting to note palpation thyroiditis seen in the thyroid specimens. It was seen in 24% of the adenomatous goiters, 17% of follicular carcinomas and 14% of the papillary carcinomas.

갑상선 유두암종에서 CD44 항원의 특이적 발현 양상

김정연,유진예,조혜제 대한병리학회 2001 Journal of Pathology and Translational Medicine Vol.35 No.4

A Case of Concurrent Papillary and Medullary Thyroid Carcinomas Detected as Recurrent Medullary Carcinoma after Initial Surgery for Papillary Carcinoma

안동빈,손진호,박지영 대한갑상선학회 2013 International Journal of Thyroidology Vol.6 No.1

As the prevalence of thyroid carcinoma is rapidly increasing, coexisting subtypes of thyroid carcinomas are often found. However, concurrent papillary and medullary carcinomas in the thyroid gland are extremely rare. We report the case of a 50-year-old man with co-occurrence of multiple papillary and medullary thyroid carcinomas; the latter were undetected at initial diagnosis. Sixty-three months after the initial operation performed because of papillary carcinoma diagnosis, a metastatic lymph node was detected in the left level IV region, which was revealed as medullary carcinoma. The histopathologic results from initial surgery were reviewed, and we found multiple coexisting medullary carcinomas that were not identified initially. The incidence of concurrent papillary and medullary thyroid carcinomas will continue to increase as rates of diagnosis of and surgery for thyroid carcinoma increase. Therefore, surgeons and pathologists should be aware of the possible coexistence of subtypes of thyroid carcinomas to avoid missing concurrent lesions.