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Related Experiment Videos

Thyroglobulin immunoreactivity in lymph node histiocytes: a potential diagnostic pitfall.

L Venkatraman1, P Maxwell, W G McCluggage

  • 1Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BL, Northern Ireland, UK. glenn.mccluggage@bll.n-i.nhs.uk

Journal of Clinical Pathology
|April 18, 2001
PubMed
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Thyroglobulin (Tg) staining in lymph nodes near thyroid cancer is common. This staining in sinus histiocytes is not metastatic tumor but rather uptake of released Tg, important for pathologists to note.

Area of Science:

  • Surgical pathology
  • Endocrine pathology
  • Oncology

Background:

  • Thyroglobulin (Tg) is a key protein produced by thyroid follicular cells.
  • Immunoreactivity for Tg in lymph nodes adjacent to thyroid malignancies has been observed.
  • The significance and frequency of this finding require further investigation.

Purpose of the Study:

  • To determine the prevalence of thyroglobulin immunoreactivity in regional lymph nodes of patients with thyroid malignancy.
  • To differentiate Tg-positive histiocytes from metastatic thyroid cancer in lymph nodes.

Main Methods:

  • Analysis of 87 lymph nodes from 21 thyroid malignancy cases (papillary, follicular, medullary, squamous, anaplastic carcinomas).
  • Inclusion of 11 control lymph nodes from patients without thyroid disease.

Related Experiment Videos

  • Immunohistochemical staining using a monoclonal antibody against thyroglobulin.

    • Main Results:

    • 32 of 87 lymph nodes (36.8%) showed positive Tg staining in sinus histiocytes.
    • Four additional cases exhibited Tg staining within lymphatic channels.
    • Positivity was found in at least one node in 15 of 21 cases (71.4%).
    • No positivity was observed in control lymph nodes.
    • No correlation between primary tumor size and Tg positivity was found.

    Conclusions:

    • Thyroglobulin immunoreactivity in sinus histiocytes of draining lymph nodes is a common finding in thyroid tumors.
    • This positivity likely results from histiocytes uptaking Tg released from damaged thyroid follicles.
    • Pathologists must be aware of this phenomenon to avoid misinterpreting it as metastatic disease.