Papillary carcinoma

T. Adachi, Y. Tajima, T. Kuroki, T. Mishima, A. Kitasato, K. Fukuda, R. Tsutsumi and T. Kanematsu, Bile-reflux into the pancreatic ducts is associated with the development of intra-ductal papillary carcinoma in hamsters, J. Surg. Res., 2006, 136(1), 106. 

Thyroid cancer Exogenous thyroid hormone may produce regression of metastases from follicular and papillary carcinoma of the thyroid and is used as ancillary therapy of these conditions with radioactive iodine. Larger doses than those used for replacement therapy are required. 

Radioactive iodine is indicated in hyperthyroidism due to Graves disease or toxic nodular goitre and also used as palliative therapy after thyroidectomy for papillary carcinoma of thyroid. 

McDougall IR, Nelsen TS, Kempson RL. Papillary carcinoma of the thyroid seven years after 1-131 therapy for Graves disease. Clin Nucl Med 1981 6(8) 368-71. 

Mackie GC, Shulkin BL. Amiodarone-induced hyperthyroidism in a patient with functioning papillary carcinoma of the thyroid and extensive hepatic metastases. Thyroid 2005 15(12) 1337-40. 

Horie, S., Maeta, H., Endo, K., Ueta, T., Takashima, K., and Terada, T. 2001. Overexpression of p53 protein and MDM2 in papillary carcinomas of the thyroid correlations with clinico-pathologic features. Pathol. International 57 11-15. 

Abnormal tissues The antibody labeled 17/20 sarcomas, 16/18 melanomas, 4/4 meningeomas, and 3/3 schwannomas, and was the sole intermediate filament present in these tumours. In addition, variable percentages (10 to 57 percent) of carcinomas, neuroendocrine carcinomas, neuroblastomas, thymomas and mesotheliomas were positive with the antibody. With the exception of the neuroblastomas, cytokeratin was coexpressed with vimentin in these tumours. Among adenocarcinomas, more than 50 percent of papillary carcinomas of the thyroid as well as renal, endometrial, ovarian and lung carcinomas were labeled by the antibody and coexpressed keratins and vimentin. 

Serke S, Riess H, Oettle H, Huhn D. Elevated reticulocyte count—a clue to the diagnosis of haemolytic-uraemic syndrome (HUS) associated with gemcitabine therapy for metastatic duodenal papillary carcinoma a case report. Br J Cancer 1999 79(9-10) 1519-21. 

One-dimensional MR spectra (Fig. 2) for 107 thyroid biopsies were analysed in this study, including 11 normal (N), 13 papillary carcinomas (PC), 4 other carcinomas (anaplastic, medullary), and 73 follicular adenomas, of which 10 were clinically manifest as follicular carcinoma (FC).46... 

NCI-H441 human pulmonary epithelial (H441) cells derived from papillary carcinoma of the lungs (ATCC). 

Tg is primarily used as a tumor marker in patients carrying a diagnosis of differentiated thyroid carcinoma (DTC). Although serum Tg is elevated in patients with thyroid cancer, including thyroid follicular and papillary carcinoma, elevations are also are seen in nonneoplastic conditions such as thyroid adenoma, subacute thyroiditis, Hashimoto s thyroiditis, and Graves disease. Serum Tg concentrations are not increased in patients with medullary thyroid carcinoma. 

Zhu Z, Ciampi R, Nikiforova MN, et al. Prevalence of RET/PTC rearrangements in thyroid papillary carcinomas effects of the detection methods and genetic heterogeneity. J Clin Endocrinol Metab. 1006 91 3603-3610. 

Sapio MR, Posca D, Troncone G, et al. Detection of BRAE mutation in thyroid papillary carcinomas by mutant allele-specific PCR amplification (MASA). Eur J Endocrinol. 2006 154 341-348. 

Nikiforova MN, Kimura ET, Gandhi M, et al. BRAE mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. J Clin Endocrinol Metab. 2003 88 5399-5404. 

The frequency of TGB positivity in thyroid carcinomas is dependent on the degree of differentiation and the histologic subtype. Generally, poorly differentiated carcinomas contain less TGB than do better-differentiated tumors. The levels of TGB mRNA are also correspondingly lower in poorly differentiated than in well-differentiated thyroid carcinomas. TGB immunoreactivity is present in more than 95% of papillary carcinomas (Figs. 10.7 and 10.8) and follicular tumors. Because TGB is also expressed in metastatic lesions, stains for this marker are particularly valuable in... 

Antibodies to T3 and T4 have been used less extensively than TGB in studies of thyroid carcinoma. Kawaoi and coworkers reported T4 positivity in 95% of papillary carcinomas and 54% of follicular carcinomas but in no cases of anaplastic thyroid carcinoma. T3 was present in 66% of papillary carcinomas, 81% of follicular carcinomas, and 45% of anaplastic carcinomas. The significance of T3 staining in the absence of T4 immunoreactivity, however, is unknown. In addition to thyroglobulin, T3, and T4, thyroid peroxidase has also been used for studies of thyroid tumors. ... 

TABLE 10.2 Cytokeratin Distribution in Papillary Carcinomas and Follicular Tumors ... 

Although CK19 is present in papillary carcinoma and in follicular tumors, the extent of staining is consistently higher in papillary carcinoma. 

There is considerable controversy with respect to the presence of CK19 in hyalinizing trabecular tumors of the thyroid. Fonseca and coworkers reported CK19 in all cases of hyalinizing trabecular tumors and suggested that this tumor represented a peculiar encapsulated variant of papillary carcinoma. Hirokawa and colleagues, in contrast, found no or minimal CK19 in their series of cases. 

The distribution of p53 has been examined in cases of thyroid carcinoma. In the series reported by Soares and coworkers, p53 was absent from 14 cases of goiter and adenoma and from 12 cases of papillary carcinoma. p53 was present in 20% of follicular carcinomas (predominantly of the widely invasive type), 16% of poorly differentiated carcinomas, and 67% of undifferentiated carcinomas. In the series reported by Holm and Nesland, 6 of 32 (19%) papillary carcinomas, 5 of 29 (17%) follicular carcinomas, and 18 of 24 (75%) undifferentiated carcinomas were p53-F. In contrast, the RB gene product was present in all thyroid carcinomas, suggesting that it does not play a major role in thyroid carcinogenesis. "... 

The ret oncogene protein has been demonstrated by immunohistochemistry both in papillary carcinomas and in a subset of hyalinizing trabecular tumors." " However, additional studies are required to ascertain the sensitivity and specificity of currently available ret antibodies in immunohistochemical formats for the identification of papillary carcinomas. 

The t(2 3)(ql3 p25) translocation, found in a subset of thyroid follicular carcinomas, results in fusion of the DNA binding domains of the thyroid transcription factor PAX-8 to domains A-F of the peroxisome proliferation-activated receptor (PPAR) y 1 (Hg. 10.13). Studies using PCR and immunohistochemistry demonstrated that most follicular carcinomas positive for PPAR Y were widely invasive while tumors lacking the rearrangement were PPAR y negative. Papillary carcinomas and Hurthle cell tumors were negative. Other studies, however, have reported positivity both in follicular carcinomas and adenomas. 

In a more recent series, Mase and colleagues demonstrated positivity in 13% of adenomatous goiters, 27% of adenomas, 84% of follicular carcinomas, and 97% of papillary carcinomas (Fig. 10.14). Among follicular neoplasms, the sensitivity for the detection of carcinomas was 84.6%, while specificity, positive predictive value, and overall accuracy were 72.6%, 66%, and 77.2%, respectively.Sack and colleagues have concluded that a positive result for HBME-1 on FNA is... 

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