Przerzut raka piersi do tarczycy jako pierwsza manifestacja choroby nowotworowej

Metastasis to the thyroid gland is uncommon compared with the frequency of primary thyroid tumors. The most common types of cancer metastatic to the thyroid gland include: carcinoma of kidney, lung, breast ovary and melanoma. In the literature, we find descriptions of cases of metastatic breast cancer patients previously diagnosed with breast carcinoma, resulting from the development of cancer. However, breast cancer metastasis to the thyroid gland, as the first manifestation of the disease is rare. Case report: 73-year-old patient with fast-growing tumor of the right thyroid lobe was admitted to the Department of Endocrinology, Holy Cross Cancer Center to diagnosis and further treatment. Many years ago she was seen because of thyroid nodular disease in euthyroid stage. Before admission fine needle aspiration biopsy of the right lobe of the thyroid nodule was done. The study found the group and individual atypical cells that suggest medullary or insular thyroid cancer. Based on cytological diagnosis-including immunohistochemistry was suspected metastatic breast cancer. On the basis of further studies revealed the presence of breast cancer metastatic to the thyroid gland. Each rapidly growing thyroid tumor should be differentiated from secondary changes in the absence of previous clinical data accompanying cancer. Immunohistochemical examination is very helpful in the clinical diagnosis.Przerzuty nowotworów do tarczycy są rzadkością w porównaniu z występowaniem pierwotnych nowotworów tarczycy. Najczęstszymi typami nowotworów dającymi przerzuty do tarczycy są: raki nerki, płuca, piersi, jajnika oraz czerniak. W piśmiennictwie można spotkać opisy przypadków przerzutów raka piersi do tarczycy z rozpoznanym wcześniej rakiem piersi, będące następstwem rozwoju choroby nowotworowej. Jednak przerzut raka piersi do tarczycy jako pierwsza manifestacja choroby występuje rzadko. W pracy przedstawiono przypadek 73-letniej pacjentki z szybko powiększającym się guzem płata prawego tarczycy, która została przyjęta na oddział endokrynologii Świętokrzyskiego Centrum Onkologii w celu diagnostyki i dalszego leczenia. Kobieta wiele lat temu była obserwowana z powodu choroby guzkowej tarczycy w stadium eutyreozy. W wykonanym przed przyjęciem na oddział badaniu cytologicznym (biopsji aspiracyjnej cienkoigłowej) z guzka płata prawego tarczycy stwierdzono grupy i pojedyncze komórki atypowe mogące sugerować raka insularnego lub rdzeniastego tarczycy. Na podstawie przeprowadzonego badania cytologicznego z uwzględnieniem immunohistochemii wysunięto podejrzenie przerzutowego raka piersi. Na podstawie dalszych badań potwierdzono obecność nowotworu piersi dającego przerzuty do tarczycy. Jak wynika z pracy, każdy szybko rosnący guz tarczycy powinien być różnicowany ze zmianą wtórną pomimo braku wcześniejszych danych klinicznych dotyczących towarzyszącej choroby nowotworowej. Badania immunohistochemiczne są bardzo pomocne w ustaleniu rozpoznania klinicznego.

Minichromosome maintenance (MCM) and AgNOR proteins expression in desmoid tumours: a tissue microarray analysis.

In the present study, nuclear proliferative proteins: MCM2, MCM5, MCM7, Ki-67 and AgNORs expression was assessed in paraffin sections from sporadic desmoid tumours using a tissue microarray (TMA)-based immuno- and histochemistry, respectively. Nuclear expression of MCM7, where the percentage of positive cells was 0.87% (Âą 1.64) (range 0-5%), was found in 4/20 (20.0%) cases. In 32/32 (100%) of the examined desmoid cases no expression of nuclear proteins MCM2 and MCM5 was detected. Nuclear expression of Ki-67 was observed in 4/21 (19%) cases. Paraffin sections from 30 cases of desmoid tumours were silver-stained to visualize AgNORs. The following AgNOR parameters were calculated: mean AgNOR number per nucleus (N), mean AgNOR area per nucleus, mean AgNOR dot area per nucleus (A), and mean AgNOR content (C = N/A). In the investigated group the mean values of AgNOR parameters were the following number: 4.34 (Âą 0.11); area: 0.74 Îźm2 (Âą 0.19); dot area: 0.18 m2 (Âą 0.01), and AgNOR content: 23.73 (Âą 1.85). The mean AgNOR number per nucleus and mean AgNOR content in desmoid tumours were statistically significantly higher as compared to the controls (tonsil tissue) (

Przydatność określania obecności mutacji BRAF V600E w biopsji aspiracyjnej celowanej cienkoigłowej w zmianach niezdeterminowanych

  Introduction: Fine-needle aspiration biopsy (FNAB) is regarded as the gold standard method for the diagnosis of thyroid nodules, but it has its limitations. Additional methods that would improve sensitivity and specificity in the diagnosis of thyroid cancer (TC), especially in indeterminate lesions. Molecular tests seem to be such a tool. BRAF V600E mutation (the most common in TC) can be detected in FNAB and can be potentially a very useful ancillary marker for FNAB practice. The aim of our study was to evaluate the usefulness of the detection of the BRAF V600E mutation in FNAC in the early diagnosis of TC in patients with indeterminate cytology. Material and method: 2290 FNAB were performed and 147 indeterminate results (group 3, 4, and 5 of the Bethesda system) were obtained. Material from these groups was submitted for molecular tests for the occurrence of BRAF V600E mutation. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the tests were calculated. Results: Determining the presence of BRAF V600E mutation in FNAC material in groups 3 and 4 together and in group 5 is associated with sensitivity of TC diagnosis of 37.5% and 81.8%, respectively. In all cases the detection of BRAF V600E mutation was associated with histopathologically proving the presence of TC (specificity of the test — 100%). Conclusions: The presence of BRAF V600E mutation in FNAC material is always associated with the presence of TC. The usefulness of determining the presence of BRAF V600E in FNAC in cytological groups 3 and 4 is associated with low sensitivity in the diagnosis of thyroid cancer. Due to its high specificity BRAF V600E study may be useful in determining the scope of surgery in patients in cytological group 5. (Endokrynol Pol 2016; 67 (1): 41–47)    Wstęp: Biopsja aspiracyjna celowana cienkoigłowa (BACC) jest uznawana za złoty standard w diagnostyce guzków tarczycy. Ma ona jednak swoje ograniczenia. Poszukiwane są więc dodatkowe metody, które poprawiłyby czułość i specyficzność diagnozowania raka tarczycy, zwłaszcza w przypadku zmian niezdeterminowanych w BACC. Badania molekularne wydają się być takim narzędziem. Mutacja BRAF V600E (najczęstsza w raku tarczycy) może być wykrywana w materiale z biopsji i może wspomagać BACC w rozpoznawaniu raka tarczycy. Celem pracy była ocena przydatności wykrywania mutacji BRAF V600E w BACC w zmianach niezdeterminowanych we wczesnej diagnostyce pacjentów ze zmianami ogniskowymi w tarczycy. Materiał i metody: Przeprowadzono 2290 BACC, uzyskując w 147 próbkach wyniki niezdeterminowane (grupy 3, 4 i 5 wg klasyfikacji Bethesda). W grupie tej przeprowadzono badania molekularne w kierunku występowania mutacji BRAF V600E. Obliczono czułość, swoistość, wartość predykcyjną dodatnią, wartość predykcyjną ujemną i dokładność testu. Wyniki: Obecność mutacji BRAF V600E w grupach cytologicznych 3 i 4 łącznie oraz w grupie 5 wiązała się z czułością w rozpoznawaniu raka tarczycy odpowiednio 37,5% i 81,8%. W każdym przypadku wykrycia mutacji BRAF V600E w badaniu pooperacyjnym rozpoznano raka tarczycy (specyficzność testu —100%). Wnioski: Obecność mutacji BRAF V600E w materiale BACC jest zawsze związana z obecnością RT. Przydatność określenia obecności BRAF V600E w BACC w grupach cytologicznych 3 i 4 jest związana z niską czułością rozpoznania RT. Ze względu na wysoką specyficzność BRAF V600E badania mogą być przydatne w określaniu zakresu operacji u pacjentów z grupy cytologicznej 5. (Endokrynol Pol 2016; 67 (1): 41–47)

The influence of the reclassification of NIFTP as an uncertain tumour on risk of malignancy for the diagnostic categories according to the Bethesda system for reporting thyroid cytopathology

Introduction: The noninvasive encapsulated, follicular variant of papillary thyroid carcinoma was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). The exclusion of NIFTP from the group of malignant tumours decreases the risk of malignancy (RoM) as defined by the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The aim of the present study was to evaluate the RoM for each category in TBSRTC with and without exclusion of NIFTP from the tally of malignancies. Material and methods: The present study included 998 thyroid nodules cases. All patients underwent diagnostic tests, including fine-needle aspiration cytology, and received surgical treatment. Slides for all resection specimens with a diagnosis of cancer were reviewed to identify NIFTP. The RoM for each of the categories in TBSRTC with and without exclusion of NIFTP from the malignant tumours was evaluated. Results: The RoM decreased with the exclusion of NIFTP from malignant categorisation with the following values for the different TBSRTC categories: non-diagnostic (ND): 0%; benign: 0%; atypia/follicular lesion of undetermined significance (AUS/FLUS): 1.6%; follicular neoplasm/suspicious for follicular neoplasm (FN/SFN): 0.7%; suspicious for malignancy (SUS): 6.9%; and malignant: 2.5%. The difference of 2.5% in the malignant category was statistically significant (p = 0.0253). Conclusions: The RoM for specific TBSRTC categories needs to be defined for each treatment centre because it is important for the selection of the appropriate surgical treatment for thyroid tumours

Four cancers related to HPV 16 infection in a 34-year-old woman

Human papilloma viruses are widespread among people. Two hundred subtypes of these viruses have been described. Most of the infections are not clinically relevant. Long-term infection by some high sub-type of human papilloma virus, however, can lead to pre-invasive and invasive cancers of urogenital organs, head and neck region, and skin. The paper presents the case of 34-year-old woman in whom four cancers associated with infection with human papilloma virus subtype 16 were diagnosed. The patient was treated with surgery and radiotherapy for cancers of the vulva, the perianal area, fingers, and cervix. This paper describes the course and outcome of the treatment

Review of prognostic and predictive aspects of mutated TP53 in Wilms’ tumor biology with morphological report and molecular analysis of 37-year-old man’s nephroblastoma

Here we review prognostic and predictive aspects of mutated TP53 in Wilms’ tumor biology on the basis of the morphological report and molecular analysis of adult nephroblastoma (diffuse blastemal pattern) of a 37-year-old man. Among quite different proteins, TP53 affects expression of several genes such as hypoxia inducible proteins GLUT1 and EPO as well as multidrug resistance (MDR) mediated by P-glycoprotein (Pgp/MDR1) and multidrug-resistant related protein (MRP1), with certain clinical implications. TP53 mutation was found both in our primary tumor (c.746G>T p.R249M frequency 92%) and in nodal metastasis (c.746G>T p.R249M frequency 90%), and the common polymorphism p.P72R in the same gene was revealed with frequency of about 97% in both primary tumor and metastatic disease with appliance of NGS technology (IonTorrent – LifeTechnology) using Ion AmpliSeq Cancer Hotspot Panel v2

An attempt to use immunohistochemical methods for semi-quantitative determination of surfactant in bronchial secretion after hyperbaric exposures

Background The most significant index of pulmonary oxygen toxicity is a decrease in vital capacity (VC) dependent on the duration of exposure and partial pressure of oxygen. The only method to measure this decrease is spirometry performed directly after exposure. Objective The aim of the study was to check whether the extent of lung damage could be assessed by quantitative determination of pulmonary surfactant in bronchial secretion. Design Sputum samples were collected before, during and after hyperbaric air or oxygen exposures; histological preparations were prepared and stained immunohistochemically to visualize surfactant. Amongst 781 samples collected, only 209 contained sputum and only 126 were included in the study. In this group, only 64 preparations could be paired for comparison. Results The semi-quantitative method used and statistical findings have not demonstrated any significance. Conclusions The method suggested for assessing the extent of lung damage has been found unsuitable for practical use due to difficulties in obtaining the proper material; moreover, the study findings do not allow to draw conclusions concerning its effectiveness