Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

<p>Abstract</p> <p>Background</p> <p>Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis.</p> <p>Case presentation</p> <p>Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with "signet ring cells" and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml.</p> <p>Discussion and Conclusion</p> <p>Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. "Signet ring cell" is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare "signet ring cells" carcinomas so far described.</p

Intestinal glucose transport in carnivorous and herbivorous marine fishes

The influx and transepithelial movements of glucose and their effects on the electrophysiology and Na transport in upper and lower intestines of the herbivorous surgeonfish, Acanthurus mata , and carnivorous eel, Gymnothorax undulatus , were measured. The K t G and J max G of glucose influx into the tissues were higher in the surgeonfish upper intestine than in the surgeonfish lower intestine or in both segments of the eel intestine. A prominent diffusion-like transport component was also measured in all four segments during influx experiments. Net transepithelial glucose fluxes (0.05 mM) were greater in eel intestine than in those of the surgeonfish largely due to an apparent lower apical membrane permeability of the former coincident with reduced backflux of glucose from epithelium to lumen. All four stripped intestinal segments exhibited non-significant (from zero; P &gt;0.05) or small, serosa-negative transepithelial potential differences (-0.1 to -2.2 mV), and low transepithelial resistances (40–88 O cm -2 ). Each tissue displayed significant ( P P &gt;0.05) change the transepithelial resistance, but did induce a significant ( P J net Na with added luminal glucose, these increased net cation fluxes were not quite significant ( P &gt;0.05). It is concluded that coupled Na-glucose transport occurs in these tissues, but that metabolic enhancement of unrelated current-generating mechanisms also takes place and may modify depolarizing effects of organic solute transfer