Histopathologic Subtypes of Surgically Resected Papillary Thyroid Carcinomas in Malatya Region+

Abstract

Abstract: Retrospective analysis of histologic subtypes of papillary thyroid carcinoma (PTC). Material and Method: Histopathology reports at the Department of Pathology, Inönü University, Medical School Malatya, Turkey revealed 33 papillary thyroid carcinoma (PTC) cases in a nine year period. Results: The demographic findings (23 females, 10 males with an average age of 45) were similar to previous reports but the distribution of the PTC subtypes showed some variation. The number and percentage of the PTC subtypes were as following: encapsulated 8 (24%), tall cell 7(21%), follicular 7 (21%), macrofollicular 5 (15%), oncocytic 3 (9%) and micro-carcinoma 3 (9%). Though the total number of the cases is not suitable for a statistical analysis incidence of the aggressive variant i.e. tall cell subtype is remarkable when compared to other series published. Lymph node metastasis was detected predominantly in the oncocytic (66.7%) and tall cell (%57.1%) subtypes. Conclusion: Tall cell and oncocytic PTC must be distinguished in the surgical pathology reports precisely for clinical evaluation due to high frequency of lymph node metastasis. Key words: Thyroid Cancer, Histopathology, Papillary Thyroid Carcinoma

Keywords

• Thyroid Cancer, Histopathology, Papillary Thyroid Carcinoma

Malatya Bölgesinde Cerrahi Uygulanmış Tiroid Papiller Kanserlerinin Histopatolojik Alt Grupları

Öz

Amaç: Papiller tiroid kanseri (PTK) alt gruplarının retrospektif analizi. Gereç ve Yöntem: Malatya İnönü Üniversitesi Tıp Fakültesi, Patoloji Laboratuarı arşivinde dokuz yıllık zaman dilimi içinde cerrahi girişimle tiroidektomi uygulanmış 33 adet PTK olgusu değerlendirildi. Bulgular: Demografik verilerin (23 kadın, 10 erkek, ortalama 45 yaş ) daha önce bildirilmiş özelliklere uyduğu görüldüyse de PTK histopatolojik alt gruplarında farklılıklar tespit edildi. PTK alt gruplarında sıklık sırasıyla, kapsüllü 8 (%24), yüksek hücreli 7 (%21), folliküler 7 (%21), makrofolliküler 5 (%15), onkositik 3 (%9) ve mikrokarsinom 3 (%9) izlendi. Toplam hasta sayısı istatiksel analize olanak vermese de kötü gidişli kabul edilen yüksek hücreli alt grup yayınlanmış serilerdekilerden fazladır. Lenf düğümü metastazları en fazla sırasıyla onkositik (%66.7) ve yüksek hücreli (%57.1) gruplarda izlendi. Sonuç: PTK içinde sık lenf düğümü yayılımı nedeniyle onkositik ve yüksek hücreli alt grupların patoloji raporlarında ayırd edilerek belirtilmesi ve klinik değerlendirmenin gerekliliği ortaya çıkmaktadır. Anahtar kelimeler: Tiroid Kanseri, Histopatoloji, Papiller Tiroid Kanseri

Anahtar Kelimeler

• Tiroid Kanseri, Histopatoloji, Papiller Tiroid Kanseri

References

1. Rosai J, Carcangiu ML, DeLellis RA. Tumors of the thyroid gland. In Rosai J, Sobin LE, ed(s). Atlas of Tumor Pathology. Third series. Fascicle 5. Washington DC: AFIP, 1992.
2. Chan JKC. Tumors of the thyroid and parathyroid glands. In Fletcher CDM (ed), Diagnostic Histopathology of Tumors. 3rd ed. Churchill Livingstone-Elsevier, 2007:997-1080.
3. Özgültekin R, Emirleroğlu M. Diferansiye tiroid kanserlerinde cerrahi patoloji. Düren M (ed), Tiroid Kanseri. Nobel Tıp Kitapevi, İstanbul, 2005:35-47.
4. Öcal K, Canbaz H, Dirlik M, Aydın Ö, Türkmenoğlu Ö, Çağlıkülekçi M, Aydın S. Tiroid mikropapiller karsinom sıklığı. Mersin Ünv. Tıp Fak Dergisi 2002;3:298-302.
5. DeLellis RA, Lloyd RV, Heitz PU, et al eds. World Health Organization Classification of Tumours, Pathology and Genetics of Tumours of Endocrine Organs. Lyon: IARC, 2004.
6. Nikiforov YE, Ohori NP. Papillary carcinoma, in: Nikiforov YE, Biddinger PW, Thompson LDR (eds), Diagnostic Pathology and Molecular Genetics of the Thyroid, Lippincott Williams and Wilkins, 2009:160-213
7. Ries LAG, Melbert D, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2004. (Based on November 2006 SEER data submission.) National Cancer Institute. Bethesda, MD. Available at: http://seer.cancer.gov/csr/
8. Parkin DM, Bray F, Ferlay J. Global cancer statistics 2002. CA Cancer J Clin 2005;55:74-108.

9. Terry JH, St John SA, Karkowski FJ, Suarez JR, Yassa NH, Platica CD, Marti JR. Tall cell papillary thyroid cancer: incidence and prognosis. Am J Surg 1994;168(5):459-61.
10. Segal K, Friedental R, Lubin E, Shvero J, Sulkes J, Feinmesser R. Papillary carcinoma of the thyroid. Otolaryngol Head Neck Surg 1995;113:356-63.
11. Pilotti S, Collini P, Manzari A, Marubini E, Rilke F Poorly differentiated forms of papillary thyroid carcinoma, distinctive entities or morphological patterns? Semin Diagn Pathol 1995;12:249-55.
12. Khan AR, Abu-Eshy SA.Variants of papillary carcinoma of the thyroid. J R Coll Surg Edinb 1998;43:20-25.
13. Muzaffar MA, Nigar E, Mushtaq S, Mamoon N. The morphological variants of papillary carcinoma of the thyroid: a clinico-pathological study--AFIP experience. Pak Med Assoc 1998;48:133-7.
14. Eyibilen A, Aladag I, Guven M, Kosboglu RD. Surgical approach to encapsulated follicular variant of papillary thyroid carcinoma, report of three cases. Kulak Burun Bogaz Ihtisas Derg 2008;18:384-8 Corresspondence address:Yrd.Doç.Dr. Emine ŞAMDANCI
15. Inönü University Medical School, Department of Pathology, MALATYA, 44280
16. Telephone: [phone]/5210
17. e-mail: [e-mail]