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07:01
An Orthotopic Mouse Model of Anaplastic Thyroid Carcinoma
Published on: April 17, 2013
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Divergent Lineage Markers in Anaplastic Thyroid Carcinoma
Wadad S Mneimneh1,2, Sylvia L Asa1
1Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University.
The American Journal of Surgical Pathology
|November 16, 2023
Summary
Anaplastic thyroid carcinoma (ATC) diagnosis can be challenging due to varied biomarker expression. This study analyzed 36 ATCs, revealing divergent lineage markers that mimic other cancers, complicating accurate identification.
Area of Science:
- Pathology
- Oncology
- Immunohistochemistry
Background:
- Anaplastic thyroid carcinoma (ATC) often arises from differentiated thyroid carcinoma (DTC).
- Diagnosis can be difficult, especially with limited biopsy samples or completely undifferentiated tumors, relying on immunohistochemical markers.
- The expression of divergent lineage markers in ATC can complicate its diagnosis and differential diagnosis from other high-grade neck malignancies.
Purpose of the Study:
- To investigate the biomarker profile of anaplastic thyroid carcinoma (ATC).
- To determine if divergent lineage markers complicate the diagnostic process for ATC.
- To assess the utility of various immunohistochemical markers in diagnosing ATC.
Main Methods:
- Retrospective analysis of 36 ATC cases with confirmed or suspected thyroid origin.
- Immunohistochemical staining was performed for a panel of markers including PAX8, TTF1, BRAFV600E, NRASQ61R, TRK, p53, p40, CDX2, SATB2, GATA3, CD117, CD163, SALL4, SMARCA4, PRAME, SOX10, ERG, and HEPPAR1.
- Cases were included if they had evidence of coexisting or antecedent DTC or a clear thyroid immunoprofile.
Main Results:
- Most ATCs were negative for TTF1, with 13 expressing PAX8.
- Mutations BRAFV600E and NRASQ61R were positive in 10/34 and 12 cases, respectively.
- Aberrant expression of GATA3 (11/36), SATB2 (8/36), CD117 (2/35), SALL4 (1/30), and CD163 (10/30) was observed, alongside p40 positivity in 5 cases with squamoid morphology.
Conclusions:
- Anaplastic thyroid carcinomas express a variety of divergent lineage markers.
- These aberrant markers can mimic other tumors, posing diagnostic challenges in the differential diagnosis of high-grade midline neck malignancies.
- Careful interpretation of immunohistochemical findings in the clinical context is crucial for accurate ATC diagnosis.
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