CONTEXT: Thyroid cancer is the most common endocrine malignancy. Within various subtypes of thyroid neoplasms, those with follicular growth pattern usually make diagnostic problems. OBJECTIVE: To examine ck19 expression as a diagnostic marker in thyroid neoplasms with follicular growth pattern. DESIGN: In this cross sectional study, 86 patients were enrolled. SUBJECTS AND METHODS: Totally 22 follicular adenoma (FA), 18 well differentiated tumors with undetermined malignant potential (WT-UMP) and 46 follicular variants of papillary thyroid carcinoma (FV-PTC) were enrolled and examined for Ck19 expression by immunohistochemistry staining. Membranous/cytoplasmic staining patterns were considered as positive. Specimens without staining were considered as 0, < 5% positively stained cells as 1+, 5%-25% as 2+, 25%-75% as 3+ and >75% as 4+. RESULT: CK19 was negative in most cases of FA while positive in most WDT-UMP and FV-PTCs, p<0.001. Additionally, most cases with 2+ and 3+ staining patterns were FV-PTC (75% and 81%, respectively, p<0.001) and none of FAs showed 3+ positivity (p<0.001). Additionally, most of strongly positive results in patients > 45 y/o were PTC (p<0.001). CONCLUSION: Ck19 is a useful marker in differentiating FA from FV-PTC. We found diffuse and strong (3+) staining pattern in FV-PTC but none of FAs were so. We concluded that diffuse and strong staining for ck19 in a thyroid lesion with follicular pattern of growth, especially in a patient older than 45 y/o should raise the possibility of malignancy.
CONTEXT: Thyroid cancer is the most common endocrine malignancy. Within various subtypes of thyroid neoplasms, those with follicular growth pattern usually make diagnostic problems. OBJECTIVE: To examine ck19 expression as a diagnostic marker in thyroid neoplasms with follicular growth pattern. DESIGN: In this cross sectional study, 86 patients were enrolled. SUBJECTS AND METHODS: Totally 22 follicular adenoma (FA), 18 well differentiated tumors with undetermined malignant potential (WT-UMP) and 46 follicular variants of papillary thyroid carcinoma (FV-PTC) were enrolled and examined for Ck19 expression by immunohistochemistry staining. Membranous/cytoplasmic staining patterns were considered as positive. Specimens without staining were considered as 0, < 5% positively stained cells as 1+, 5%-25% as 2+, 25%-75% as 3+ and >75% as 4+. RESULT: CK19 was negative in most cases of FA while positive in most WDT-UMP and FV-PTCs, p<0.001. Additionally, most cases with 2+ and 3+ staining patterns were FV-PTC (75% and 81%, respectively, p<0.001) and none of FAs showed 3+ positivity (p<0.001). Additionally, most of strongly positive results in patients > 45 y/o were PTC (p<0.001). CONCLUSION: Ck19 is a useful marker in differentiating FA from FV-PTC. We found diffuse and strong (3+) staining pattern in FV-PTC but none of FAs were so. We concluded that diffuse and strong staining for ck19 in a thyroid lesion with follicular pattern of growth, especially in a patient older than 45 y/o should raise the possibility of malignancy.
Authors: P S de Matos; A P Ferreira; F de Oliveira Facuri; L V M Assumpção; K Metze; L S Ward Journal: Histopathology Date: 2005-10 Impact factor: 5.087
Authors: Yoon-La Choi; Mi Kyung Kim; Jin-Won Suh; Joungho Han; Jung Han Kim; Jung Hyun Yang; Seok Jin Nam Journal: J Korean Med Sci Date: 2005-10 Impact factor: 2.153
Authors: Ricardo V Lloyd; Lori A Erickson; Mary B Casey; King Y Lam; Christine M Lohse; Sylvia L Asa; John K C Chan; Ronald A DeLellis; H Ruben Harach; Kennichi Kakudo; Virginia A LiVolsi; Juan Rosai; Thomas J Sebo; Manuel Sobrinho-Simoes; Bruce M Wenig; Marick E Lae Journal: Am J Surg Pathol Date: 2004-10 Impact factor: 6.394