Cervical Paraganglioma Mimicking Thyroid Nodule: A Rare Clinical Case

Objective. Paraganglioma is a rare neuroendocrine tumor. When it is located in the neck, it is commonly misdiagnosed as other thyroid neoplasms. Case Report. We report a case of cervical paraganglioma in a 55-year-old female. Patient was admitted to our clinic with goiter and neck pain. Thyroid ultrasonography revealed a 20 mm solitary, heterogeneous nodule located in the upper pole of left thyroid lobe. Fine needle aspiration cytology was nondiagnostic. She underwent left lobectomy and histopathology showed paraganglioma. Discussion. Cervical paragangliomas should be considered in the differential diagnosis of thyroid nodules

Papillary microcarcinomas of the thyroid gland and immunohistochemical analysis of expression of p53 protein in papillary microcarcinomas

BACKGROUND: Thyroid papillary microcarcinoma (TPM) is defined according to WHO criteria as a thyroid tumor smaller than 1–1.5 cm. TPMs are encountered in 0.5–35.6 % of autopsies or surgical specimens where carcinoma had been unsuspected. The purpose of the present study was to evaluate patients who had TPMs in terms of clinical findings, histopathological features and immunohistochemical evidence of expression of the tumor suppressor gene p53. METHODS: A total of 44 patients with TPMs less than 1.0 cm in diameter were included in the study. The patients were evaluated clinically and the tumors were evaluated in terms of their histopathological and immunohistochemical features, including expression of p53. RESULTS: The female/male ratio was 2.8/1, and the median age at time of diagnosis was 49 years (range 20–71 years). The maximum diameter of the smallest focus was 0.1 mm, and that of the largest was 10 mm microscopically. The mean diameter of all tumors was 5.7 mm. There was no correlation between tumor size and age or gender. Of the TPMs, 72 % were found in the right lobe, 24 % in the left lobe and 4 % in the isthmus. Fine-needle aspiration biopsy provided the diagnosis of TPM in only 43.2 % of the patients. All patients were treated with surgery, with 20 undergoing conservative surgery, i.e. lobectomy or isthmusectomy, and 24 undergoing total thyroidectomy. Frozen section provided the diagnosis of TPM in only 56.8 % of the patients. We found lymphocytic thyroiditis in 13.6% of patients, follicular variants in 11.9%, capsular invasion in 26.8%, lymph node involvement in 11.9%, soft tissue metastases in the neck in 12.1% and multifocality in 31.7 %, and none of these were related to age or gender (p > 0.05). No distant metastases were observed during approximately 10 years of follow up. We found p53 positivity in 34.5 % of TPM tumors. However, p53 expression was not statistically related to age or gender. CONCLUSION: Our findings imply that TPMs may not be entirely innocent since they are associated with signs of poor prognosis such as capsular invasion, multifocal presentation, lymph node involvement and p53 positivity. Therefore, TPMs should be evaluated and followed like classical papillary cancers

Normal ve tümörleşmiş meme dokusunda GST izozimlerinin ekspresyonlarının karşılaştırılması: klinik ve prognoz faktörlerle ilişkisi

Meme dokusunda bulunan Glutatyon-S-transferazlar, meme tümörlerinin kemoterapiye verdiği cevapta ve karsinojenlerin mutajenik etkilerine duyarlılıkta önemlidir. Bu çalışmada, 43 invasif duktal kanser ve normal meme dokusunda glutatyon-S-transferaz enzimlerinin (alfa, mü, pi ve teta) immünohistokimyasal boyanma özellikleri araştırılmıştır. Ayrıca, GST izozimlerinin salınımları ve hastaların klinik özellikleri arasındaki ilişkiler de tespit edilmiştir. GST alfa, mü, pi ve teta izozimleri, vakaların % 100’ünde normal ve tümörlü meme dokularında farklı boyanma şiddetinde ve yaygın sitoplazmik olarak tespit edildi. GST alfa, mü ve pi enzimleri normal epitelde invasif tümör dokularına göre daha şiddetli boyanma göstermiştir (P 0,05). Ancak, istatistiksel olarak normal ve tümör epitel hücrelerinde GST teta salınımlarında bir fark tespit edilmemiştir (P 0,05). Bu çalışmada, mikrokalsifikasyon durumu ve GST mü; menapoz durumu ve GST alfa; tumor evresi ve GST mü salınımları arasında önemli bir ilişki gözlenmiştir (P 0,05). GST izozimleri ile estrojen reseptör durumu, evre, sigara içimi, kemoterapi, çocuk sayısı, yaş ve hormon terapi durumu arasında istatistiksel olarak bir ilişki bulunamamıştır (P 0,05).Glutathione S-transferases in breast tissue play an important role in the susceptibility to the mutagenic effects of chemical carcinogens and in the response of breast tumors to chemotherapy. In this study the immunohistochemical staining characteristics of glutathione S-transferase isoenzymes (alpha, mu, pi, and theta) were investigated in invasive duct carcinomas and in normal breast tissue of 43 patients. The relationships between the expression of the GST isoenzymes and some clinicopathological features were also examined. Diffuse cytoplasmic staining of varying intensity was observed for GST alpha, theta, and pi in normal and tumorous breast tissue in 100% of the samples. In normal epithelium there was a stronger intensity of staining for GST alpha, mu, and pi expression than in invasive tumor tissues (P 0.05). In this study significant relationships were observed between microcalcification status and GST mu, between menopause status and GST alpha, and between tumor grade and GST mu expression (P 0.05)

Comparison of GST Isoenzyme Expression in Normal and Neoplastic Breast Tissue: Correlation with Clinical and Prognostic Factors

Sak, Serpil/0000-0003-3666-3095WOS: 000266892000001Glutathione S-transferases in breast tissue play an important role in the susceptibility to the mutagenic effects of chemical carcinogens and in the response of breast tumors to chemotherapy. In this study the immunohistochemical staining characteristics of glutathione S-transferase isoenzymes (alpha, mu, pi, and theta) were investigated in invasive duct carcinomas and in normal breast tissue of 43 patients. The relationships between the expression of the GST isoenzymes and some clinicopathological features were also examined. Diffuse cytoplasmic staining of varying intensity was observed for GST alpha, theta, and pi in normal and tumorous breast tissue in 100% of the samples. In normal epithelium there was a stronger intensity of staining for GST alpha, mu. and pi expression than in invasive tumor tissues (P 0.05). In this study significant relationships were observed between microcalcification status and GST mu, between menopause status and GST alpha, and between tumor grade and GST mu expression (P 0.05).Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK); British CouncilThis study was supported by grants from the Scientific and Technological Research Council of Turkey (TUBITAK), and the British Council

Vascular Endothelial Growth Factor (Vegf)-C, Vegf-D, Vegfr-3 And D2-40 Expressions In Primary Breast Cancer: Association With Lymph Node Metastasis

Background. Two members of the vascular endothelial growth factor (VEGF) family, VEGF-C and -D, are known as lymphangiogenic growth factors and play an important role in tumor lymphangiogenesis via activation of the VEGF receptor (VEGFR)-3, which is expressed in lymphatic endothelial cells. D2-40 is a specific antibody for lymphatic vessel density (LVD). Objectives. In the present study, we have aimed to evaluate whether intra-and peri-tumoral D2-40-positive lymphatic vessels affect lymph node metastasis and to investigate the relationship between LVD and lymph node metastasis in breast cancer. Material and methods. We have evaluated the relationships between lymph node metastasis and VEGF-C, VEGF-D, VEGFR-3 and D2-40 expressions in breast cancer cells using immunohistochemistry. VEGF-C, VEGF-D and VEGFR-3 expression were found in tumor cells in the majority of the cases (83.75, 97.5 and 95%, respectively). Results. There was a significant positive relationship between VEGF-D expression and lymph node metastasis (p < 0.05) however no significant association was found in VEGF-C and VEGFR-3 expressions. It was found that patients with high-expression of VEGF-D have a high level of both peri-and intra-tumoral LVD compared to those with low expression of VEGF-D (p < 0.05). Conclusions. Our results support that examination of VEGF-D expression in breast cancer cells may be beneficial in the identification of lymph node metastasis.WoSScopu

Cervical Paraganglioma Mimicking Thyroid Nodule: A Rare Clinical Case

Objective. Paraganglioma is a rare neuroendocrine tumor. When it is located in the neck, it is commonly misdiagnosed as other thyroid neoplasms. Case Report. We report a case of cervical paraganglioma in a 55-year-old female. Patient was admitted to our clinic with goiter and neck pain. Thyroid ultrasonography revealed a 20 mm solitary, heterogeneous nodule located in the upper pole of left thyroid lobe. Fine needle aspiration cytology was nondiagnostic. She underwent left lobectomy and histopathology showed paraganglioma. Discussion. Cervical paragangliomas should be considered in the differential diagnosis of thyroid nodules

Diffuse Neuroendocrine Cell Hyperplasia: Report of Two Cases

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder characterised by a proliferation of neuroendocrine cells within the lung. It is believed that a minority of the patients with DIPNECH can develop carcinoid tumors. Here, we report two new cases of DIPNECH with coexisting carcinoid tumors

Hazards of the ‘hard cash’: Hypersensitivity pneumonitis

Hypersensitivity pneumonitis (HP) is a nonimmunoglobulin E-related immune-mediated parenchymal lung disease. A 45-year-old woman who was a lifelong nonsmoker with a six-month history of frequent episodes of cough and dyspnea was admitted to hospital. She had been working as a money counter for 20 years at a central bank. Bibasilar crackles on lung auscultation, ground-glass opacities and a mosaic pattern on high-resolution computed tomography, restrictive abnormality on pulmonary function tests and mild hypoxemia were the prominent findings. Bronchoalveolar lavage fluid analysis revealed a predominance of CD4-positive T cells, and she tested positive on her natural challenge test. She was diagnosed with subacute HP based on established criteria. She was advised to discontinue counting fresh banknotes. Prednisolone was commenced, then tapered to discontinue in the ensuing six months. Clinical and radiological improvement was achieved within two months. To the authors’ knowledge, the present report is the first to describe ‘hard cash HP’, possibly caused by chipping dust or printing dye

Intrapulmonary Solitary Fibrous Tumour of the Lung: A Very Unusual Presentation

Solitary fibrous tumour (SFT) is a rare neoplasm which most frequently occurs in the pleura, especially visceral pleura, but it is known that intrapulmonary SFT is very rare. We report the case of a 60-year-old woman who was admitted with a 6-year history of slow enhancing intrapulmonary nodular lesion in her right upper lobe on chest computed tomography (CT). A right upper lobectomy was performed for complete excision of the tumour and the postoperative histopathological examination revealed SFT. No pathology was observed during the period of 34-month postoperative follow-up. Herein we present an extremely rare case of intrapulmonary SFT that was located in the deep pulmonary parenchyma

Thyroid Gland Metastasis from Cancer of the Uterine Cervix: An Extremely Rare Case Report

The thyroid gland is a relatively uncommon site for a metastatic disease, although it is richly supplied with blood. The metastases may originate from various primary sites, mainly kidney, lung, head and neck, and breast. Thyroid metastasis from cervical carcinomas is extremely rare; and only a few cases have been previously reported in the literature. In patient with thyroid nodules and an oncological history, the possibility of thyroid metastasis should be seriously considered. Despite the rarity of the metastasis of cervical carcinoma to the thyroid, it is difficult to say appropriate treatment approach for these lesions. When managing such patients, decision-making should balance the possibility of gaining long-term survival against estimation of the aggressiveness of the disease and its possible complications. Here, a case of thyroid metastasis from a squamous cell carcinoma of the uterine cervix presenting with cervical mass and difficulty in swallowing and its treatment is reported