Thyroid pathology: differences and controversies between the pathology report and clinical interpretation. Part I: prognostic factors
DOI:
https://doi.org/10.35509/01239015.188Keywords:
Thyroid cancer, Papillary carcinoma, Follicular neoplasmAbstract
Cancer of the thyroid gland is a neoplasia for which its detection, diagnosis and treatment is interdisciplinary. For this reason, the definitive diagnosis by histopathology should be complete and clear so that it can be interpreted in the same way by the treating medical group. Non-pathology physicians who receive the report of a histopathological study of the thyroid often have difficulties when interpreting the report and therefore in defining the subsequent medical behaviour. The objective of this first article is to review briefly some of the different subjects that generate most doubts in the interpretation of the histopathology report, and the diagnostic techniques used in pathology by the attending physicians that have an impact on clinical decisions arising from the classification, staging, prognosis, and follow-up of the disease.
Author Biographies
Alfredo Ernesto Romero Rojas, Instituto Nacional de Cancerología
Grupo Patología Oncológica, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
Rafael Parra Medina, Fundación Universitaria de Ciencias de la Salud
Grupo de Epidemiología, Facultad de Medicina, Fundación Universitaria de Ciencias de la Salud, Bogotá D. C., Colombia
Sandra Isabel Chinchilla Olaya, Instituto Nacional de Cancerología
Grupo Patología Oncológica, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
Amelia de los Reyes Victoria, Instituto Nacional de Cancerología
Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
Augusto Llamas Olier, Instituto Nacional de Cancerología
Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
References
Tufano RP, Noureldine SI, Angelos P. Incidental thyroid nodules and thyroid cancer: considerations before determining management. JAMA Otolaryngol Head Neck Surg. 2015;141:566-72.
https://doi.org/10.1001/jamaoto.2015.0647
National Cancer Institute. SEER Stat Fact Sheets: Thyroid Cancer [Internet]. 2015. Disponible en: http://seer.cancer.gov/statfacts/html/thyro.html
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69-90.
https://doi.org/10.3322/caac.20107
DeLellis RA, Lloyd R, Heitz P, Eng C. Pathology and Genetics of Tumours of Endocrine Organs. Third edition IARC; 2004.
Pardo C, Cendales R. Incidencia, mortalidad y prevalencia de cáncer en Colombia, 2007-2011. Primera edicio'ın. Bogotá. D. C.: Instituto Nacional de Cancerologi'ıa.; 2015. p. 232.
Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006;295:2164-7.
https://doi.org/10.1001/jama.295.18.2164
Al-Brahim N, Asa SL. Papillary thyroid carcinoma: an overview. Arch Pathol Lab Med. 2006;130:1057-62.
Nikiforov Y, Biddinger P, Thompson L, Diagnostic Pathology. Molecular Genetics of the Thyroid. En: Second edition. Lippincott- Wolters Kluwer; 2012.
Lloyd RV, Buehler D, Khanafshar E. Papillary thyroid carcinoma variants. Head Neck Pathol. 2011;5:51-6.
https://doi.org/10.1007/s12105-010-0236-9
Asioli S, Erickson LA, Sebo TJ, Zhang J, Jin L, Thompson GB, et al. Papillary thyroid carcinoma with prominent hobnail features: a new aggressive variant of moderately differentiated papillary carcinoma. A clinicopathologic, immunohistochemical, and molecular study of eight cases. Am J Surg Pathol. 2010;34:44-52.
https://doi.org/10.1097/PAS.0b013e3181c46677
Ivanova R, Soares P, Castro P, Sobrinho-Simões M. Diffuse (or multinodular) follicular variant of papillary thyroid carcinoma: a clinicopathologic and immunohistochemical analysis of ten cases of an aggressive form of differentiated thyroid carcinoma. Virchows Arch. 2002;440:418-24.
https://doi.org/10.1007/s00428-001-0543-3
Ghossein R, Asa S, Barnes L, Chan J, Harrison L, Heffess C. Protocol for the Examination of Specimens from Patients with Carcinomas of the Thyroid Gland Protocol applies to all carcinomas of the thyroid gland. Lymphomas, sarcomas and metastases are not included. Coll Am Pathol. 2012:2-27.
Sobin LH, Gospodariwicz MK, Wittekind C. TNM classification of malignant tumors. New York: UICC International Union against Cancer; 2009.
Pellegriti G, Frasca F, Regalbuto C, Squatrito S, Vigneri R. Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol. 2013;2013:965212.
https://doi.org/10.1155/2013/965212
Cano-Valdez A. Aspectos histolo'ıgicos del cáncer diferenciado de la tiroides. Rev Colomb Cancerol. 2004;4:73-84.
Kakudo K, Tang W, Ito Y, Mori I, Nakamura Y, Miyauchi A. Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group. J Clin Pathol. 2004;57:1041-6.
https://doi.org/10.1136/jcp.2004.017889
Lang BH, Lo CY, Chan WF, Lam KY, Wan KY. Staging systems for papillary thyroid carcinoma: a review and comparison. Ann Surg. 2007;245:366-78.
https://doi.org/10.1097/01.sla.0000250445.92336.2a
Lopes JP, Fonseca E. [BRAF gene mutation in the natural history of papillary thyroid carcinoma: diagnostic and prognostic implications]. Acta Med Port. 2011;24 Suppl 4: 855-68.
Santarpia L, Myers JN, Sherman SI, Trimarchi F, Clayman GL, El-Naggar AK. Genetic alterations in the Ras/Raf/mitogenactivated protein kinase and phosphatidylinositol 3-kinase/Akt signaling pathways in the follicular variant of papillary thyroid carcinoma. Cancer. 2010;116:2974-83.
https://doi.org/10.1002/cncr.25061
Romero A, Cuervo-Martínez J, Osorio-Arango L, Olaya N. Histological variants and prognostic factors of papillary thyroid carcinoma at the National Cancer Institute of Colombia. Biomedica. 2015;35:429-36.
Nikiforov YE, Erickson LA, Nikiforova MN, Caudill CM, Lloyd RV. Solid variant of papillary thyroid carcinoma: incidence, clinical-pathologic characteristics, molecular analysis, and biologic behavior. Am J Surg Pathol. 2001;25:1478-84.
https://doi.org/10.1097/00000478-200112000-00002
Asioli S, Odasso C, Macrì L, Palestini N, Bussolati G. Merits of the PMiT (papillary microtumor) terminology in the definition of a subset of incidental papillary microcarcinomas of the thyroid. Int J Surg Pathol. 2009;17:378-83.
https://doi.org/10.1177/1066896908321181
Meza-Cabrera IA, Romero-Rojas A. Terminología y análisis de los hallazgos citológicos e histopatológicos en el estudio del nódulo tiroideo. Recomendaciones de la Asociación Colombiana de Endocrinología, Diabetes y Metabolismo para el diagnóstico y manejo de las Enfermedades Tiroideas. 2015:35-48.
Cadena E, Romero A, Moreno A. Microcarcinoma papilar de tiroides (MCPT) metastásico a hueso. Reporte de caso. Rev Colomb Cancerol. 2011;15:44-9.
https://doi.org/10.1016/S0123-9015(11)70072-5
Hay ID, Hutchinson ME, Gonzalez-Losada T, Mc Iver B, Reinalda ME, Grant CS, et al. Papillary thyroid microcarcinoma: A study of 900 cases observed in a 60-year period. Surgery. 2008;144:980-8.
https://doi.org/10.1016/j.surg.2008.08.035
Zafon C, Baena JA, Castellví J, Obiols G, Monroy G, Mesa J. Differences in the Form of Presentation between Papillary Microcarcinomas and Papillary Carcinomas of Larger Size. J Thyroid Res. 2011;2010:639156.
https://doi.org/10.4061/2011/639156
Baloch ZW, LiVolsi VA. Follicular-patterned lesions of the thyroid: The bane of the pathologist. Am J Clin Pathol. 2002;117:143-50.
https://doi.org/10.1309/8VL9-ECXY-NVMX-2RQF
Williams E. Guest editorial: two proposals regarding the terminology of thyroid tumors. Int J Surg Pathol. 2000;8:181-3.
https://doi.org/10.1177/106689690000800304
LiVolsi VA. Papillary neoplasms of the thyroid. Pathologic and prognostic features. Am J Clin Pathol. 1992;97:426-34.
https://doi.org/10.1093/ajcp/97.3.426
Carcangiu ML, Zampi G, Pupi A, Castagnoli A, Rosai J. Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy. Cancer.1985;55:805-28.
https://doi.org/10.1002/1097-0142(19850215)55:4<805::AID-CNCR2820550419>3.0.CO;2-Z
Garavito G, Llamas Olier A, Cadena E, De los Reyes A, Hurtado G, Rojas L, et al. Manejo multidisciplinario del cáncer diferenciado de tiroides en el Instituto Nacional de Cancerología. Rev Colomb Cancerol. 2010;14:65-77.
https://doi.org/10.1016/S0123-9015(10)70100-1
Wang LY, Ghossein R, Palmer FL, Nixon IJ, Tuttle RM, Shaha AR, et al. Microscopic Positive Margins in Differentiated Thyroid Cancer Is Not an Independent Predictor of Local Failure. Thyroid. 2015;25:993-8.
https://doi.org/10.1089/thy.2015.0141
Fletcher C. Diagnostic Histopathology of Tumors. 4 th ed Philadelphia: Saunders-Elsevier; 2013.
Garavito G. Factores pronósticos para recaída en pacientes con cáncer papilar de tiroides. Rev Colomb Cancerol. 2005;9:21-30.
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