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Poorly differentiated thyroid carcinoma with pleomorphic giant cells-a case report.
Alexia Gazeu1, Jonathan Lopez2,3, Serge Guyetant4
1Pathology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
Virchows Archiv : an International Journal of Pathology
|April 3, 2020
Summary
Poorly differentiated thyroid carcinoma (PDTC) can present with pleomorphic giant cells, challenging traditional classifications. This finding suggests these cells do not always indicate a more aggressive thyroid neoplasm.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Poorly differentiated thyroid carcinoma (PDTC) has a prognosis intermediate between well-differentiated carcinomas and anaplastic thyroid carcinomas (ATC).
- Pleomorphic giant cells are typically associated with ATC or non-neoplastic thyroid conditions.
Observation:
- A case study of a 43-year-old woman with a 34mm thyroid nodule is presented.
- Histological examination revealed an encapsulated tumor with solid growth, capsular and angioinvasion, and intermingled medium-sized and pleomorphic giant tumor cells.
- Immunoprofile (keratins +, TTF1+, Pax 8+) confirmed thyroid origin; Next-Generation Sequencing (NGS) identified no molecular alterations.
Findings:
- The patient's tumor met histological criteria for PDTC according to the Turin proposal, but notably featured pleomorphic giant cells.
- Clinical, histological, and immunohistochemical features distinguished this case from ATC.
- Absence of recurrence after 24 months post-surgery and radioiodine therapy.
Implications:
- Pleomorphic tumor giant cells can occur in PDTC and may not necessarily signify dedifferentiation or a more aggressive thyroid neoplasm.
- This case expands the understanding of histological variations within PDTC.
- Re-evaluation of diagnostic criteria for thyroid neoplasms may be warranted.
