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Published on: April 17, 2013
Solid and cystic ultimobranchial body remnants in the thyroid
M E Beckner1, J J Shultz, T Richardson
1Department of Pathology, University of Alabama, Birmingham.
Insights
Ultimobranchial body remnants are common in neonatal thyroids, often appearing cystic. Their nuclear features can mimic papillary thyroid carcinoma, necessitating their inclusion in differential diagnoses of small thyroid lesions.
Area of Science:
- Endocrinology
- Surgical Pathology
- Developmental Biology
Background:
- The ultimobranchial body (UBB) is a transient structure during embryonic development.
- UBB remnants are frequently identified in adult thyroid glands, often misclassified.
- Understanding UBB remnant morphology is crucial for accurate thyroid pathology diagnosis.
Purpose of the Study:
- To determine the incidence and characterize the morphology of ultimobranchial body (UBB) remnants in neonatal thyroid glands.
- To compare the morphological features of UBB remnants with papillary thyroid carcinoma.
Main Methods:
- Serial sectioning of 18 neonatal thyroid glands.
- Morphological analysis of identified UBB remnants.
- Comparative nuclear feature assessment with follicular cells and papillary carcinoma nuclei.
Main Results:
- High incidence rate (89%) of UBB remnants observed.
- 55% of UBB remnants exhibited cystic features, challenging the 'solid cell nests' designation.
- Ciliated columnar cells were present in 23% of remnants.
- UBB cell nuclei shared features with papillary thyroid carcinoma nuclei (enlarged, oval, finely dispersed chromatin).
Conclusions:
- UBB remnants are a common finding in neonatal thyroids with diverse morphology, including cystic changes.
- Morphological and nuclear similarities between UBB remnants and papillary thyroid carcinoma highlight diagnostic challenges.
- Recognition of UBB remnant features is essential for the differential diagnosis of minute thyroid entities.
Abstract:
In this study we determined the incidence rate (89%) and characterized the morphology of ultimobranchial body (UBB) remnants found in 18 serially sectioned neonatal thyroid glands. Although UBB remnants are often referred to as solid cell nests, we found cystic features in 55%. Ciliated columnar cells were seen in 23%. One contained a large pseudo-papilla. The UBB cells had nuclei with features reminiscent of papillary carcinoma nuclei in that they were enlarged, oval, and contained finely dispersed chromatin when compared with follicular cell nuclei. Both papillary carcinomas and UBB remnants are common, occur as tiny, solid, or cystic thyroid entities in patients of all ages, may contain papillary structures, and share some common nuclear features. Therefore, it is important to include UBB remnants in the differential diagnosis of minute thyroid entities and to recognize their morphologic features.
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