Morphology Aspects of Hypothyroidism

Hypothyroidism is a common endocrine disorder resulting of low levels of thyroid circulating hormones. The prevalence in the general population varies between 0.3% and 3.7%. Presents as clinical or subclinical disease based on presence of symptoms and levels of serum TSH and free thyroxine and T4, respectively. Hypothyroidism has numerous etiologies, some of them are originated on the thyroid itself and some others are of extrathyroid origin, with variable manifestations. Classified as primary, secondary, tertiary and peripheral. Thyroid autoimmune disease is the principal cause. A new class of drugs against cancer, like the anti-CTLA-4 and anti-PD-L1/PD1 therapies have been associated with primary or secondary hypothyroidism. Endocrine disorders can be difficult to diagnose based only on morphological features because endocrine manifestations are caused primarily by a hormonal imbalance. Hypothyroidism may have a higher risk of morbidity and mortality. Finally, myxedematous coma is the main complication of terminal stages hypothyroidism

Occult Follicular Thyroid Carcinoma presenting as Primary Breast Tumor with Sternal and Skull Metastasis

Introduction: Follicular thyroid carcinoma (FTC) that initially presented as breast tumor with no previous medical history of malignancy of thyroid gland is relatively rare and may cause diagnostic confusion.Presentation of case: We report a 59-year-old Mexican woman with no prior history of malignant thyroid neoplasm that presents with pain and swelling in the upper outer quadrant of the left breast with a year of evolution. Subsequently, subcutaneous tumor was identified in left parietal region. Clinically it was thought in primary breast tumor metastasis to skull. Furthermore, computerized tomography scan identified a tumor in the deep portion of the left breast, infiltrating the sternum that subsequently was confirmed a follicular carcinoma of the thyroid gland.Conclusion: Metastatic FTC may mimic a primary breast tumor. The combined use of clinical information, histopathology and immunohistochemistry were important to establishing a correct cancer diagnosis

Concordancia de biopsia incisional y escisional en receptores hormonales y her2 en cáncer de mama

Introduction: El cáncer de mama es la principal causa de mortalidad por cáncer en mujeres mexicanas. Objetivo: Identificar la concordancia entre la biopsia con aguja de corte (BAC) y la biopsia escisional (BE) con respecto al diagnóstico, receptores hormonales (RH) y Her2. Material y Métodos: Se registró el número de fragmentos cilíndricos, datos demográficos, tipo histológico y tratamiento. Se recopilaron resultados de RH y Her2. Resultados: Se incluyeron 70 mujeres con mediana de edad de 58 años. El diagnóstico inicial en BAC fue carcinoma ductal invasivo 56 (80%), lobular 10 (14%) y mixtos 4 (6%). El acuerdo de diagnóstico entre BAC y BE fue del 97%, k = 0.65. Se observó una concordancia de 92% (k = 0.75), 75% (k = 0.26) y 67% (k = 0.46) para las determinaciones de receptor de estrógenos (RE), receptor de progesterona (RP) y Her2, y los valores predictivos positivos en BAC fueron 0.96, 0.89 y 0.44, respectivamente. Conclusión: Los RH y la concordancia de Her2 mediante inmunohistoquímica (IHC) manual se encuentran dentro del rango de valores obtenidos mediante el uso de IHC automatizada. Los errores técnicos/de lectura contribuyeron más a discordancia que la heterogeneidad tumoral