Follicular carcinoma of the thyroid with extensive clear-cell differentiation: A potential diagnostic pitfall

✍ Scribed by Benjamin G. Ropp; Charalombos Solomides; Juan Palazzo; Marluce Bibbo

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 97 KB
• Volume: 23
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/1097-0339(200009)23:3<222::aid-dc19>3.0.co;2-8

✦ Synopsis

Clear-cell features have been recognized in several different thyroid neoplasms. A case of thyroid follicular carcinoma with extensive clear- and Hurthle-cell features is described in a 37-yr-old white female, with cytochemical and immunohistochemical analysis. The tumor of the thyroid gland, with anterior neck soft-tissue extension, displayed clear cells on fine-needle aspiration, which were negative for thyroglobulin. The surgical specimen displayed predominately clear cells (80%), and only the nonclear-cell areas stained for thyroglobulin. Proper categorization of clear-cell lesions of the thyroid and soft tissues requires a multimodality approach, involving clinical/pathological correlation, morphological analysis, and ancillary tissue studies. Immunohistochemical stains for thyroglobulin are quite definitive in making the distinction between primary clear-cell thyroid tumors vs. metastatic clear-cell tumors. Cytologists should be aware, however, that the clear-cell areas of thyroid tumors might not stain for thyroglobulin.