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BRAF mutation in solid cell nest hyperplasia associated with papillary thyroid carcinoma. A precursor lesion?
José Cameselle-Teijeiro1, Ihab Abdulkader, Raquel Pérez-Becerra
1Department of Pathology, Clinical University Hospital, Galician Health Service, University of Santiago de Compostela, 15706 Santiago de Compostela, Galicia, Spain. josemanuel.cameselle@usc.es
Human Pathology
|March 10, 2009
Summary
Solid cell nest hyperplasia may precede papillary thyroid carcinoma. Genetic analysis revealed shared BRAF mutations between solid cell nests and adjacent papillary microcarcinoma, suggesting a common origin.
Area of Science:
- Endocrinology
- Oncopathology
- Molecular Genetics
Background:
- Solid cell nests (SCNs) are common thyroid Ccell inclusions of uncertain significance.
- Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy.
Observation:
- A case of SCN hyperplasia co-occurring with follicular variant papillary microcarcinoma (FVPTC) in a 48-year-old male with goiter was examined.
- Histological analysis revealed close contact between SCN cells and FVPTC.
- p63-positive cells were observed in the second FVPTC.
Findings:
- Microdissection and genetic analysis demonstrated the identical BRAF(V600E) mutation in both a pool of SCNs and adjacent FVPTC.
- The second FVPTC harbored BRAF(V600E) and a novel BRAF(G593D) mutation.
- No BRAF mutations were detected in the follicular adenoma or other SCN pools.
Implications:
- These findings support a histogenetic link between SCNs and PTC.
- SCN hyperplasia is suggested as a potential precursor lesion for PTC.
- Understanding SCNs' role may impact thyroid cancer risk assessment and early detection strategies.
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