CDX2 Expression in Some Variants of Papillary Thyroid Carcinoma

Cameselle-Teijeiro, José; Alberte-Lista, Lara; Peteiro-González, Diego; Abdulkader-Nallib, Ihab; Reyes-Santías, Rosa M; Soares, Paula; Sobrinho-Simões, Manuel

doi:10.1309/ajcp1bgca6mfcnkh

Cited by 11 publications

(15 citation statements)

References 11 publications

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“…PTC‐CCV has long been recognized as an independent entity . It recently has come to the attention of pathologists due to the unexpected and controversial immunohistochemical finding of the expression of CDX2 (caudal type homeobox 2), which has been considered as a putative differentiation marker …”

Section: Discussionmentioning

confidence: 99%

Columnar cell variant of papillary thyroid carcinoma: Cytomorphological characteristics of 11 cases with histological correlation and literature review

Bongiovanni

Mermod

Canberk

et al. 2017

Cancer Cytopathology

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Section: Discussionmentioning

confidence: 99%

Columnar cell variant of papillary thyroid carcinoma: Cytomorphological characteristics of 11 cases with histological correlation and literature review

Bongiovanni

Mermod

Canberk

et al. 2017

Cancer Cytopathology

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“…In both the cribriform-morular variant of thyroid carcinoma and in all biotin-rich optically clear nuclei family tumors, CD10 is a useful tool for identifying morules [82]. The morular structures are also positive for CDX2, an intestinespecific homeobox gene transcription factor [83]. The apparently incongruent CDX2 (along with CD10 and CA19.9) expression in this tumor type fits with the primitive (noncommitted differentiation) intestinal-like phenotype that our group proposed for some thyroid tumors many years ago [84].…”

Section: Immunohistochemistrymentioning

confidence: 99%

Cribriform-morular variant of thyroid carcinoma: a neoplasm with distinctive phenotype associated with the activation of the WNT/β-catenin pathway

et al. 2018

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Cribriform-morular variant of thyroid carcinoma is classically associated with familial adenomatous polyposis but, it can also occur as a sporadic neoplasm. This neoplasm is much more frequently observed in women than in men (ratio of 61:1). In familial adenomatous polyposis patients, tumors are generally multifocal and/or bilateral (multinodular appearance), whereas in the sporadic cases tumors tend to occur as single nodules. The tumors are well delimited, and characteristically show a blending of follicular, cribriform, papillary, trabecular, solid, and morular patterns. Neoplastic cells are tall or cuboidal with the occasional nuclear features of classic papillary thyroid carcinoma. The morules include cells with peculiar nuclear clearing and show positivity for CDX2 and CD10. Angioinvasion and capsular invasion have been described in about 30 and 40% of cases, respectively, with lymph node metastases in less than 10% of patients and distant metastases in 6%. Although this tumor has good prognosis, neuroendocrine and/or poor differentiation have been associated with aggressive behavior. Tumor cells can be focally positive or negative for thyroglobulin, but are always positive for TTF-1, estrogen and progesterone receptors, and negative for calcitonin and cytokeratin 20. Nuclear and cytoplasmic staining for β-catenin is the hallmark of this tumor type; this feature plays a role in fine needle aspiration biopsy. Cribriform-morular variant of thyroid carcinoma has a peculiar endodermal (intestinal-like) type phenotype, activation of the WNT/β-catenin signaling pathway, and belongs to the non-BRAF-non-RAS subtype of the molecular classification of thyroid tumors. Elevated expression of estrogen and progesterone receptors and activation of the WNT/β-catenin pathway may prove useful as putative therapeutic targets in cases that do not respond to conventional therapy. Clinicians should be alerted to the possibility of familial adenomatous polyposis when a diagnosis of cribriform-morular variant of thyroid carcinoma is made. Instead of being considered as a variant of papillary thyroid carcinoma its designation as cribriform-morular thyroid carcinoma seems more appropriate.

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“…CDX2 is expressed in normal intestinal epithelium, neoplasms of intestinal origin and occasionally tumours with intestinal‐type morphology. The utility of CDX2 in the diagnosis of a columnar cell variant has been debatable because of its variable expression in this variant (10%–55%) and expression in conventional and cribriform‐morular variants . These tumours also show variable thyroglobulin expression, so it is the fairly constant expression of TTF1 which is most helpful in diagnosing this variant .…”

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confidence: 62%

Cytomorphology and immunocytochemistry of columnar cell variant of papillary thyroid carcinoma

2017

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and experience in general cytopathology whereas about half said that in practice they did not. What is the answer? Clinical specialisation is a reality and has to be accommodated; everyone can not become an expert in everything. | A PROPOSED SOLUTION FOR GENERAL AND SPECIALIST CYTOPATHOLOGYThe answer for cytopathology is to take on the European principle of the 'common trunk' and teach cytology along with histology from the earliest opportunity. Medical students should see both when learning about basic concepts of microscopy in normal, benign and malignant conditions; attendance at multidisciplinary meetings gives them the opportunity to place microscopic appearances in a clinical context; familiarity with cytology from an early stage and up to the FRCPath Part 2 examination would enable them to enjoy recognizing the elegance of the cytology of normal structures and the specificity of the cytology of many tumours and lesions.Post-FRCPath trainees should be expected to spend time working in centres with high standards of cytopathology in their chosen clinical speciality or specialities. They need not report both when they become consultants: they may either report cytopathology in general and histopathology as a specialist subject or report both (or one or other) in one or more clinical specialities. With all these options basic training in cytopathology alongside histopathology would allow pathologists in all specialities, including gynaecological pathology, either to develop their own expertise in cytopathology or to make sure that others in their departments do so.In the absence of a Diploma in Cytopathology there is no provision for trainees to demonstrate a commitment to cytology. Perhaps they should be encouraged to take an MD in a cytology-related topic-bearing in mind that without an MD pathology qualifications are incomplete in many countries (including the USA and India).Added to a final College examination that need not include cervical cytopathology pathology trainees are likely to become isolated from the world at large as well as from the rest of Europe-but conforming to the UEMS guidelines would at least avoid Brexit meaning Brexit for our trainees.

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CDX2 Expression in Some Variants of Papillary Thyroid Carcinoma

Cited by 11 publications

References 11 publications

Columnar cell variant of papillary thyroid carcinoma: Cytomorphological characteristics of 11 cases with histological correlation and literature review

Columnar cell variant of papillary thyroid carcinoma: Cytomorphological characteristics of 11 cases with histological correlation and literature review

Cribriform-morular variant of thyroid carcinoma: a neoplasm with distinctive phenotype associated with the activation of the WNT/β-catenin pathway

Cytomorphology and immunocytochemistry of columnar cell variant of papillary thyroid carcinoma

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