Cytokeratin 19, p63 and CD56 in Assessing Papillary Thyroid Carcinoma when the Morphology is not Clear: Experience at the Hospital Universitario San Ignacio
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Apr 24, 2013
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Abstract
Papillary carcinoma of the thyroid (PC) is diagnosed in most of the cases only by H&E morphology; however, the diagnosis in some cases became quite difficult, and the lesion can be over-called, for example, when the lesion has a capsule or when there are florid hyperplastic changes in goiter. And it is well known that a misdiagnosis of a PC can bring important clinical consequences. Studies have showed that immunohistochemistry can be helpful in those cases, however several markers have been proposed. We assessed expression of three marker proposed in other study (CK19, CD56 and p63) in PC and non-papillary lesions, neoplastic and non-neoplastic. 29 cases of PC were included and 31 cases on non-papillary lesions 96 % of PC were strongly positive for CK19, and 90 % were CD56 negative. Only 64 % of all PC shower focal positivity for p63. 100 % of the cases of nonpapillary lesion were strongly positive for CD56 and negative for CK19. With these results, we were able to confirm previous findings about the use of CK19 and CD56 could be useful in the cases of PC when the morphology on H&E is doubtful.
Keywords
carcinoma, thyroid, pathology, carcinoma, tiroides, patología,
References
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19. Zeromski J, Bagnasco M, Paolieri F, Dworacki G. Expression of CD56 (NKH-1) differentiation antigen in human thyroid epithelium. Clin Exp Immunol. 1992;89:474-8.
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23. Preto A, Reis-Filho JS, Ricardo S, Soares P. P63 expression in papillary and anaplastic carcinomas of the thyroid gland: lack of an oncogenetic role in tumorigenesis and progression. Pathol Res Pract. 2002;198:449-54.
24. Baloch ZW, LiVolsi VA. Warthin-like papillary carcinoma of the thyroid. Arch Pathol Lab Med. 2000;124:1192-5.
25. Urano M, Abe M, Kuroda M et al. Warthin-like tumor variant of papillary thyroid carcinoma: Case report and literature review. Pathol Interl. 2001;51:707-12.
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2. DeLellis RA, Lloyd RV, Heits PU, Eng C, editors. World Health Organization Classification of Tumours: pathology and genetics of tumours of endocrine organs. Lyon: IARC Press; 2004.
3. El Demellawy DE, Nasr A, Alowami S. Application of CD56, P63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid. Diagn Pathol. 2008;3:5.
4. Asa SL, Cheung CC. The mind´s eye. Am J Clin Pathol. 2001;16: 635-6.
5. Chan JKC. Strict criteria should be applied in the diagnosis of encapsulated follicular variant of papillary thyroid carcinoma. Am J Clin Pathol. 2002;117:16-8.
6. Baloch ZW, LiVolsi VA. Follicular-patterned lesions of the thyroid: the bane of the pathologist. Am J Clin Pathol. 2002;117:143-50.
7. Lloyd RV, Erickson LA, Casey MB et al. Observer variation in the diagnosis of follicular variant of papillary thyroid carcinoma. Am J Surg Pathol. 2004;28:1336-40.
8. Hirokawa M, Carney JA, Goellner JR et al. Observer variation of encapsulated follicular lesions of the thyroid gland. Am J Surg Pathol. 2001;26(11):1508-14.
9. Rosai J, Kuhn E, Carcangiu ML. Pitfalls in thyroid tumour pathology. Histopathol. 2006;49:107-20.
10. Perez-Montiel MD, Suster S. The spectrum of histologic changes in thyroid hyperplasia: a clinicopathologic study of 300 cases. Hum Pathol. 2008;39:1080-7.
11. Cheung CC, Ezzat S, Freeman J, Rosen IB, Asa SL. Immunohistochemical diagnosis of papillary thyroid carcinoma. Mod Path. 2001;14(4):338-42.
12. Fisher S, Asa SL. Application of immunohistochemistry to thyroid neoplasms. Arch Pathol Lab Med. 2008;132:359-70.
13. Bartolazzi A, Gasbarri A, Papotti M, Bussolati G, Lucante T et al. Application of an immunodiagnostic method for improving preoperative diagnosis of nodular thyroid lesions. Lancet. 2001;357:1644-50.
14. Rezk S, Khan A. Role of immunohistochemistry in the diagnosis and progression of follicular epithelium-derived thyroid carcinoma. Appl Immunohistochem Mol Morphol. 2005;13(3):256-61.
15. Choi YL, Kim MK, Suh JW, Han J et al. Immunoexpression of HBME-1, high molecular weight cytokeratin, cytokeratin 19, thyroid transcription factor-1, and E-cadherin in thyroid carcinomas. J Korean Med Sci. 2005;20:853-9.
16. Lam KY, Lui MC, Lo CY. Cytokeratin expression profiles in thyroid carcinomas. Eur J Surg Oncol. 2001;27:631-5.
17. Baloch ZW, Abraham S, Roberts S, Livolsi VA. Differential expression of cytokeratins in follicular variant of papillary carcinoma: an immunohistochemical study and its diagnostic utility. Hum Pathol. 1999;30(10):1166-70.
18. Sahoo S, Hoda SA, Rosai J, DeLellis RA. Cytokeratin 19 immunoreactivity in the diagnosis of papillary thyroid carcinoma: a note of caution. Am J Clin Pathol. 2001;116:696-702.
19. Zeromski J, Bagnasco M, Paolieri F, Dworacki G. Expression of CD56 (NKH-1) differentiation antigen in human thyroid epithelium. Clin Exp Immunol. 1992;89:474-8.
20. Cavallaro U, Niedermeyer J, Fuxa M, Christofori G. N-CAM modulates tumorcell adhesion to matrix by inducing FGFreceptor signaling. Nature Cell Biol. 2001;3:650-7.
21. Prag S, Lepekhin EA, Kolkova K, Hartmann-Petersen, Kawa A, Walmod PS, Belman V, Gallagher HC. NCAM regulates cell motility. J Cell Scienc. 2002;115:283-92.
22. Levrero M, De Laurenzi V, Costanzo A, Sabatini S, Gong J, Wang JYJ, Mellino G. The p53/p63/p73 family of transcription factors: overlapping and distinct functions. J Cell Sci. 2000;113:1661-70.
23. Preto A, Reis-Filho JS, Ricardo S, Soares P. P63 expression in papillary and anaplastic carcinomas of the thyroid gland: lack of an oncogenetic role in tumorigenesis and progression. Pathol Res Pract. 2002;198:449-54.
24. Baloch ZW, LiVolsi VA. Warthin-like papillary carcinoma of the thyroid. Arch Pathol Lab Med. 2000;124:1192-5.
25. Urano M, Abe M, Kuroda M et al. Warthin-like tumor variant of papillary thyroid carcinoma: Case report and literature review. Pathol Interl. 2001;51:707-12.
26. Kim H, Myssiorek D, Heller K, Zahurullah F, Bhuiya T. Warthin-like tumor of the thyroid gland: An uncommon variant of papillary thyroid cancer. Ear, Nose Throat J. 2006;85(1):56-9.
How to Cite
Bolívar, I. C., Rodríguez, J. L., Jaramillo García, L. F., & Mejía, M. (2013). Cytokeratin 19, p63 and CD56 in Assessing Papillary Thyroid Carcinoma when the Morphology is not Clear: Experience at the Hospital Universitario San Ignacio. Universitas Medica, 54(2), 165–174. https://doi.org/10.11144/Javeriana.umed54-2.ccac
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