Hyalinizing trabecular tumor of the thyroid: case report
Hyalinizing trabecular tumor (HTT) of the thyroid originates from the follicular cell and is a rare entity. It predominates in women at the age of 50 years. It owes its name to its histologic appearance, composed of preferentially elongated cells, arranged in trabeculae with dense intra- and intertr...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/35059 |
| Aporte de: |
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I10-R327-article-35059 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
thyroid gland thyroid neoplasms thyroid nodule hyalinizing trabecular tumor hyalinizing trabecular adenoma glándula tiroides neoplasias tiroidea nódulo tiroideo tumor trabecular hialinizante adenoma trabecular hialinizante |
| spellingShingle |
thyroid gland thyroid neoplasms thyroid nodule hyalinizing trabecular tumor hyalinizing trabecular adenoma glándula tiroides neoplasias tiroidea nódulo tiroideo tumor trabecular hialinizante adenoma trabecular hialinizante Taddei, E Borgarello, P Tradotti , MV Gönc, V Cremonezzi, DC Ferro, A Gambi, C Szlabi, S Hyalinizing trabecular tumor of the thyroid: case report |
| topic_facet |
thyroid gland thyroid neoplasms thyroid nodule hyalinizing trabecular tumor hyalinizing trabecular adenoma glándula tiroides neoplasias tiroidea nódulo tiroideo tumor trabecular hialinizante adenoma trabecular hialinizante |
| author |
Taddei, E Borgarello, P Tradotti , MV Gönc, V Cremonezzi, DC Ferro, A Gambi, C Szlabi, S |
| author_facet |
Taddei, E Borgarello, P Tradotti , MV Gönc, V Cremonezzi, DC Ferro, A Gambi, C Szlabi, S |
| author_sort |
Taddei, E |
| title |
Hyalinizing trabecular tumor of the thyroid: case report |
| title_short |
Hyalinizing trabecular tumor of the thyroid: case report |
| title_full |
Hyalinizing trabecular tumor of the thyroid: case report |
| title_fullStr |
Hyalinizing trabecular tumor of the thyroid: case report |
| title_full_unstemmed |
Hyalinizing trabecular tumor of the thyroid: case report |
| title_sort |
hyalinizing trabecular tumor of the thyroid: case report |
| description |
Hyalinizing trabecular tumor (HTT) of the thyroid originates from the follicular cell and is a rare entity. It predominates in women at the age of 50 years. It owes its name to its histologic appearance, composed of preferentially elongated cells, arranged in trabeculae with dense intra- and intertrabecular hyaline material. In FNA (fine needle aspiration puncture) it is usually diagnosed as indeterminate or suspicious category according to the Bethesda system (TBS), since cytologically it resembles papillary or medullary carcinoma. The evolutive course is usually benign, but the 2017 WHO Classification considers it as borderline/precursor tumor, taking into account its potential for dissemination. The importance of a correct diagnosis lies in the conservative treatment for TTH.
Seventeen-year-old patient referred to the endocrinology service for polycystic ovary syndrome. Physical examination: thyroid nodule, ultrasonographically measuring 2x2x1.5 cm (TI-RADS 4a), was punctured. FNA was reported as category IV TBS, follicular neoplasm/suspected follicular neoplasm. Surgery was decided. Macroscopy: total thyroidectomy surgical specimen, right lobe measured 3x3x1.7 cm; left lobe 3x2x1.5 cm and isthmus. Capsule opaque and congestive. In the right lobe: solid whitish nodular lesion with well-defined borders measuring 2x2x1.5 cm. Rest of the parenchyma: normal appearance. Apart 3 lymph nodes and 2 fragments of parathyroid. It was processed and stained with the usual technique, then immunohistochemistry. Microscopy: the nodule showed a proliferation of follicular cells arranged in anastomosing trabeculae separated by a finely vascularized stroma, with a myxoid aspect in some areas and fibrosclerotic in others. The cells had fused nuclei with some nuclear clefts and ample eosinophilic cytoplasm, occasional mitosis figures. The capsule was complete and undamaged. The rest of the thyroid gland, lymph nodes and parathyroid: preserved. Immunohistochemistry positive for thyroglobulin, TTF-1 and CD56, negative for calcitonin, synaptophysin and chromogranin, Ki67: 3%. Therefore, the diagnosis was: hyalinizing trabecular tumor.
Although TTH has a low incidence, in the presence of a morphological aspect that suggests its diagnosis, it is necessary to differentiate it from entities such as papillary, follicular and medullary carcinomas, pathologies with a more aggressive course that require oncologic treatment. The therapeutic indication for TTH is lobectomy. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/35059 |
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I10-R327-article-350592024-04-15T16:19:09Z Hyalinizing trabecular tumor of the thyroid: case report Tumor trabecular hialinizante de tiroides: comunicación de un caso Taddei, E Borgarello, P Tradotti , MV Gönc, V Cremonezzi, DC Ferro, A Gambi, C Szlabi, S thyroid gland thyroid neoplasms thyroid nodule hyalinizing trabecular tumor hyalinizing trabecular adenoma glándula tiroides neoplasias tiroidea nódulo tiroideo tumor trabecular hialinizante adenoma trabecular hialinizante Hyalinizing trabecular tumor (HTT) of the thyroid originates from the follicular cell and is a rare entity. It predominates in women at the age of 50 years. It owes its name to its histologic appearance, composed of preferentially elongated cells, arranged in trabeculae with dense intra- and intertrabecular hyaline material. In FNA (fine needle aspiration puncture) it is usually diagnosed as indeterminate or suspicious category according to the Bethesda system (TBS), since cytologically it resembles papillary or medullary carcinoma. The evolutive course is usually benign, but the 2017 WHO Classification considers it as borderline/precursor tumor, taking into account its potential for dissemination. The importance of a correct diagnosis lies in the conservative treatment for TTH. Seventeen-year-old patient referred to the endocrinology service for polycystic ovary syndrome. Physical examination: thyroid nodule, ultrasonographically measuring 2x2x1.5 cm (TI-RADS 4a), was punctured. FNA was reported as category IV TBS, follicular neoplasm/suspected follicular neoplasm. Surgery was decided. Macroscopy: total thyroidectomy surgical specimen, right lobe measured 3x3x1.7 cm; left lobe 3x2x1.5 cm and isthmus. Capsule opaque and congestive. In the right lobe: solid whitish nodular lesion with well-defined borders measuring 2x2x1.5 cm. Rest of the parenchyma: normal appearance. Apart 3 lymph nodes and 2 fragments of parathyroid. It was processed and stained with the usual technique, then immunohistochemistry. Microscopy: the nodule showed a proliferation of follicular cells arranged in anastomosing trabeculae separated by a finely vascularized stroma, with a myxoid aspect in some areas and fibrosclerotic in others. The cells had fused nuclei with some nuclear clefts and ample eosinophilic cytoplasm, occasional mitosis figures. The capsule was complete and undamaged. The rest of the thyroid gland, lymph nodes and parathyroid: preserved. Immunohistochemistry positive for thyroglobulin, TTF-1 and CD56, negative for calcitonin, synaptophysin and chromogranin, Ki67: 3%. Therefore, the diagnosis was: hyalinizing trabecular tumor. Although TTH has a low incidence, in the presence of a morphological aspect that suggests its diagnosis, it is necessary to differentiate it from entities such as papillary, follicular and medullary carcinomas, pathologies with a more aggressive course that require oncologic treatment. The therapeutic indication for TTH is lobectomy. El tumor trabecular hialinizante (TTH) de tiroides se origina de la célula folicular y constituye una entidad poco frecuente. Predomina en mujeres a los 50 años. Debe su nombre a la apariencia histológica, compuesta por células preferentemente alargadas, dispuestas en trabéculas con material hialino denso intra e intertrabecular. En la PAAF (punción aspiración aguja fina) suele diagnosticarse como categoría indeterminada o sospechosa según el sistema Bethesda (TBS), ya que citológicamente se asemeja al carcinoma papilar o medular. El curso evolutivo generalmente es benigno, pero la Clasificación de la OMS de 2017 lo considera como tumor borderline/precursor, teniendo en cuenta su potencial de diseminación. La importancia de un correcto diagnóstico radica en el tratamiento conservador para el TTH. Paciente de 17 años derivada al servicio de endocrinología por síndrome de ovario poliquístico. Examen físico: nódulo tiroideo, que ecográficamente medía 2x2x1,5 cm (TI-RADS 4a), se punzó. La PAAF se informó como categoría IV TBS, neoplasia folicular/sospechosa de neoplasia folicular. Se decidió cirugía. Macroscopia: pieza quirúrgica de tiroidectomía total, el lóbulo derecho midió 3x3x1,7 cm; lóbulo izquierdo 3x2x1,5 cm e itsmo. Cápsula opaca y congestiva. En lóbulo derecho: lesión nodular blanquecina sólida de bordes bien definidos de 2x2x1,5 cm. Resto del parénquima: aspecto normal. Aparte 3 ganglios y 2 fragmentos de paratiroides. Se procesó y coloreó con técnica habitual, posteriormente inmunohistoquímica. Microscopia: el nódulo mostró una proliferación de células de aspecto folicular dispuestas conformando trabéculas anastomosadas separadas por estroma finamente vascularizado, en sectores aspecto mixoide y en otros fibroesclerótico. Las células presentaron núcleos fusados con algunas hendiduras nucleares y citoplasmas amplios eosinófilos, ocasionales figuras de mitosis. La cápsula estaba completa e indemne. El resto de la glándula tiroides, ganglios y paratiroides: conservados. Inmunohistoquímica positiva para tiroglobulina, TTF-1 y CD56, negativa para calcitonina, sinaptofisina y cromogrania, Ki67: 3%. Por lo cual se diagnosticó: tumor trabecular hialinizante. Si bien el TTH tiene baja incidencia, ante un aspecto morfológico que sugiera su diagnóstico se impone diferenciarlo de entidades como los carcinomas papilar, folicular y medular, patologías de curso más agresivo que requieren de tratamiento oncológico. En tanto la indicación terapéutica para el TTH es la lobectomía. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto https://revistas.unc.edu.ar/index.php/med/article/view/35059 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |