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Multiple pulmonary neoplasia positive for thyroglobulin.
I Torres1, A Garcia, M J Palomo
1Division of Endocrinology, Puerta del Mar Hospital, Cadiz, Spain.
Journal of Endocrinological Investigation
|June 22, 2005
Summary
This study reports a rare case of metastatic pulmonary carcinoid tumor that tested positive for thyroglobulin. This finding presents diagnostic challenges in distinguishing it from metastatic differentiated thyroid cancer.
Area of Science:
- Oncology
- Pathology
- Endocrinology
Background:
- Differentiated thyroid carcinoma and carcinoid tumors are distinct neuroendocrine neoplasms.
- Thyroglobulin is a specific marker for differentiated thyroid carcinoma.
- Carcinoid tumors typically express neuroendocrine markers like neuron-specific enolase and synaptophysin.
Observation:
- A 73-year-old woman presented with mediastinal mass and pulmonary nodules suggestive of metastatic thyroid carcinoma.
- Radioiodine (I131) uptake was observed in the metastatic lesions.
- Histological and immunohistochemical analysis revealed a carcinoid tumor.
Findings:
- The carcinoid tumor showed positive immunohistochemistry for neuron-specific enolase, synaptophysin, and unexpectedly, thyroglobulin.
- Chromogranin and calcitonin were negative, which is typical for carcinoid tumors but atypical for medullary thyroid carcinoma.
- This case represents the first documented instance of a thyroglobulin-positive pulmonary carcinoid metastasis.
Implications:
- The presence of thyroglobulin in a carcinoid tumor complicates the differential diagnosis of metastatic neuroendocrine neoplasms.
- This finding highlights the importance of comprehensive immunohistochemical evaluation for accurate tumor classification.
- Further research may be needed to understand the biological basis and diagnostic implications of thyroglobulin expression in carcinoid tumors.