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Benign nodular goiter with spindle cell component

Mitsuyoshi Hirokawa1, Reiji Haba, Yoshio Kushida

  • 1Department of Diagnostic Pathology, Kuma Hospital, Kobe, Japan. mhirokawa@kuma-h.or.jp

Pathology International
|July 13, 2010
PubMed

Insights

Three benign nodular goiters showed a spindle cell component. These spindle cells are non-neoplastic, derived from follicular cells, and important to distinguish from aggressive thyroid cancers.

Area of Science:

  • Endocrinology
  • Surgical Pathology
  • Thyroid Oncology

Background:

  • Nodular goiters can present with diverse histopathological features.
  • Distinguishing benign thyroid lesions from malignant ones is crucial for patient management.

Observation:

  • Three cases of benign nodular goiter exhibited a spindle cell component.
  • Spindle cells were bland with pale/clear cytoplasm, arranged in fascicles or nests.
  • A clear transition between follicular cells and spindle cells was observed.

Findings:

  • Immunohistochemistry confirmed thyroglobulin and thyroid transcription factor-1 positivity in spindle cells.
  • Spindle cells were negative for CD34 and showed low Ki-67 (MIB-1) proliferation index (<1%).
  • These findings support a follicular cell origin and non-neoplastic nature of the spindle cells.

Implications:

  • Recognition of this benign spindle cell lesion is vital to avoid misdiagnosis.
  • Accurate differentiation from aggressive thyroid malignancies like papillary or anaplastic carcinoma is essential.
  • This finding aids in appropriate clinical and surgical decision-making for thyroid nodules.

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