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Cytokeratin 5/6 and P63 immunophenotype of thyroid lymphoepithelial complexes
Adriana Handra-Luca1, Ema Dragoescu2
1APHP GHU Avicenne, Universite Paris Nord Sorbonne Cite, France.
Insights
Thyroid lymphoepithelial complexes (LECos) are rare findings. Immunohistochemical analysis suggests they may arise from squamous metaplasia in autoimmune thyroiditis or specific immune backgrounds.
Area of Science:
- Endocrinology
- Pathology
- Immunohistochemistry
Background:
- Thyroid lymphoepithelial complexes (LECos) are uncommon and have been observed in various thyroid conditions, including lymphoma, Graves-Basedow disease, Hashimoto thyroiditis, and pericarcinomatous thyroid tissue.
- Their precise origin and significance remain incompletely understood.
Purpose of the Study:
- To investigate the immunohistochemical profile of thyroid LECos.
- To explore potential associations between thyroid LECos and specific clinical or pathological features.
Main Methods:
- Analysis of 6 cases of thyroid LECos using immunohistochemistry for cytokeratin 5/6 (CK5/6), P63, and TTF1.
- Review of clinical history, including treatments (e.g., carbimazole) and allergies (e.g., NSAID, povidone-iodine).
- Microscopic examination of thyroid tissue for associated lesions such as nodular goiter, lymphocytic thyroiditis, and other anomalies.
Main Results:
- CK5/6 and P63 were expressed in both basaloid and squamoid LECos, indicating squamous differentiation.
- TTF1 expression was weak or absent.
- Associated findings included nodular goiter, lymphocytic thyroiditis, papillary thyroid microcarcinoma, solid cell nest, thyroglossal duct remnant, lymphoepithelial cyst, and thymus-parathyroid unit.
Conclusions:
- Thyroid LECos may be associated with autoimmune thyroiditis or a specific immune susceptibility.
- The expression of CK5/6 and P63 supports a metaplastic origin for LECos, rather than abnormal migration.
- Further research is needed to fully elucidate the etiologic relevance of these findings.
Abstract:
Thyroid lymphoepithelial complexes (LECos) are rare, being reported in lymphoma, Graves-Basedow disease, Hashimoto thyroiditis, pericarcinomatous thyroid or in the context of branchial cleft-like cysts. Here we report immunohistochemical expression of cytokeratin 5/6, P63 and TTF1 in 6 cases of thyroid LECos. Two cases had carbimazole treatment for hyperthyroidia and Graves disease. Anti-thyroglobulin, -thyroperoxidase or -TSH antibodies were detected in 4 cases. NSAID or poviodone iodine allergy were present in 2 cases. The treatment consisted in total thyroidectomy or lobectomy. Microscopy showed nodular goiter and focal lymphocytic thyroiditis. Basaloid LECos were seen in all thyroids while squamoid LECos in 2. Associated lesions were papillary thyroid microcarcinoma (2 cases), solid cell nest, thyroglosal duct remnant, lymphoepithelial cyst and thymus-parathyroid unit (one case each). Cytokeratin 5/6 was expressed in both squamoid and basaloid LECos along with P63. TTF1 expression was faint or absent. In conclusion LECos may occur in the context of autoimmune thyroiditis or of a specific immune susceptibility background. The expression of CK5/6 and of P63 suggests a squamous differentiation including in the basaloid LECos. The etiologic relevance of these immunostainings remains limited although rather suggestive of a metaplastic process than of migration-abnormalities.
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