Papillary thyroid carcinoma with prominent myofibroblastic stromal component: clinicopathologic, immunohistochemical and next-generation sequencing study of seven cases.
Adult
Aged
Biomarkers, Tumor
/ metabolism
Female
High-Throughput Nucleotide Sequencing
Humans
Immunohistochemistry
Male
Middle Aged
Mutation
Myofibroblasts
/ metabolism
PAX8 Transcription Factor
/ genetics
Proto-Oncogene Proteins B-raf
/ genetics
Stromal Cells
/ metabolism
Thyroid Cancer, Papillary
/ genetics
Thyroid Gland
/ metabolism
Thyroid Neoplasms
/ genetics
Young Adult
beta Catenin
/ genetics
Journal
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
ISSN: 1530-0285
Titre abrégé: Mod Pathol
Pays: United States
ID NLM: 8806605
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
07
01
2020
accepted:
24
03
2020
revised:
23
03
2020
pubmed:
16
4
2020
medline:
21
7
2021
entrez:
16
4
2020
Statut:
ppublish
Résumé
Papillary thyroid carcinoma with desmoid-type fibromatosis or nodular fasciitis-like stroma is an extremely unusual and poorly understood subtype of papillary thyroid cancer. Although prior studies have demonstrated alterations in the Wnt/β-catenin signaling pathway in some of these tumors, controversy still exists regarding the nature of the stromal spindle component. We have studied seven cases of papillary thyroid carcinoma with prominent myofibroblastic stroma, including six men and one woman aged 20-65 years (mean age = 44). All cases displayed areas consistent with conventional papillary thyroid carcinoma embedded in abundant myofibroblastic-like stroma. The myofibroblastic stroma in six cases resembled desmoid-type fibromatosis and in one case it more closely resembled nodular fasciitis. By immunohistochemical staining, the stromal spindle component showed positivity for SMA and low MIB1 proliferation index in all cases, and there was at least patchy strong nuclear positivity for beta-catenin in six/seven cases. Stains for cytokeratin AE1/AE3 and PAX8 were positive in the epithelial elements but negative in the stromal component. Next-generation sequencing was performed on six of seven cases. CTNNB1 gene mutations were identified in six/seven cases. The epithelial component showed BRAF mutations in two cases and an NRAS mutation in one case. The case with fasciitis-like stroma was negative for beta-catenin by sequencing and immunostaining as well as negative for USP6 gene rearrangement. Our findings indicate that papillary thyroid carcinoma with prominent myofibroblastic stroma may represent more than one category of lesions.
Identifiants
pubmed: 32291398
doi: 10.1038/s41379-020-0539-7
pii: S0893-3952(22)00699-8
doi:
Substances chimiques
Biomarkers, Tumor
0
CTNNB1 protein, human
0
PAX8 Transcription Factor
0
PAX8 protein, human
0
beta Catenin
0
BRAF protein, human
EC 2.7.11.1
Proto-Oncogene Proteins B-raf
EC 2.7.11.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1702-1711Commentaires et corrections
Type : CommentIn
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