Cytologic Features of Fine Needle Aspirates of Papillary and Mucoepidermoid Carcinoma of the Thyroid with Anaplastic Transformation

Cameselle-Teijeiro, José; Febles-Pérez, Carmen; Sobrinho-Simões, Manuel

doi:10.1159/000333537

Cited by 20 publications

(8 citation statements)

References 8 publications

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“…Our case showed, in retrospect, cytologic features of papillary, mucoepidermoid and anaplastic carcinoma. 5 In accordance with Geisinger et al, 1 we found cytomorphologic features of MEC in the form of malignant cellular sheets showing definite glandular structures (with hyaline bodies) and squamoid differentiation. In our case, the eosinophils were intermingled with neutrophils in a necrotic background that correlated well with the anaplastic areas.…”

supporting

confidence: 90%

“…5 However, we were not able to identify hyaline bodies in the figures published by Geisinger et al 1 nor did we find any specific reference to the presence or absence of these structures in the smears of these cases. It remains therefore disputable whether the aforementioned criteria may be used in the cytologic diagnosis of SMECE.…”

Section: To the Editorcontrasting

confidence: 66%

“…We agree that primary mucoepidermoid carcinomas (MEC) of the thyroid are rare, indolent tumors with a low-grade malignant potential. SMECE are also extremely rare neoplasms, which were first reported by Chan 5 In our case, the markedly fibrotic stroma of the areas of the primary tumor resembling MEC was infiltrated by mature neutrophils and eosinophils. Metastatic foci mimicking MEC and including eosinophilic infiltrate were found in 2 of the 6 lymph nodes.…”

Section: To the Editorsupporting

confidence: 49%

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Cytomorphologic Features of Mucoepidermoid Carcinoma of the Thyroid

Cameselle-Teijeiro¹,

Sobrinho‐Simöes²

1999

Am J Clin Pathol

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We read with interest the paper by Geisinger et al 1 reporting 2 patients with sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) of the thyroid. We agree that primary mucoepidermoid carcinomas (MEC) of the thyroid are rare, indolent tumors with a low-grade malignant potential. SMECE are also extremely rare neoplasms, which were first reported by Chan et al 2 as a variant of MEC associated with a low-grade biologic course without distant metastases or tumor-related deaths. However, as Geisinger et al 1 pointed out, based on the study of their cases as well as that of Bondeson et al, 3 metastatic dissemination may also occur in SMECE. Our studies of a unique thyroid tumor showing a combination of papillary, mucoepidermoid and undifferentiated carcinoma and its cytologic features on fine needle aspirates (FNA) were recently published. 4-5 In our case, the markedly fibrotic stroma of the areas of the primary tumor resembling MEC was infiltrated by mature neutrophils and eosinophils. Metastatic foci mimicking MEC and including eosinophilic infiltrate were found in 2 of the 6 lymph nodes. 4 To the best of our knowledge, our case 4 and another case reported by Franssila et al 6 were the only 2 cases of MEC in which the patients died as a result of their thyroid tumors; curiously, foci of anaplastic transformation were observed in both cases. It has been postulated that MEC originates from solid cell nests, which in turn are thought to be of ultimobranchial body derivation. "9 While the histologic and immunohistochemical findings of our case 4 supported the aforementioned histogenetic hypothesis, we concur with Geisinger et al 1 that this view is controversial. Our case showed, in retrospect, cytologic features of papillary, mucoepidermoid and anaplastic carcinoma. 5 In accordance with Geisinger et al, 1 we found cytomorphologic features of MEC in the form of malignant cellular sheets showing definite glandular structures (with hyaline bodies) and squamoid differentiation. In our case, the eosinophils were intermingled with neutrophils in a necrotic background that correlated well with the anaplastic areas. Taking in consideration that lumina containing eosinophilic, colloid-like, PASpositive material (hyaline bodies) are a constant finding in MEC,

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confidence: 90%

Section: To the Editorcontrasting

confidence: 66%

Section: To the Editorsupporting

confidence: 49%

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Cytomorphologic Features of Mucoepidermoid Carcinoma of the Thyroid

Cameselle-Teijeiro¹,

Sobrinho‐Simöes²

1999

Am J Clin Pathol

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“…2 The second case was a primary papillary and mucoepidermoid carcinoma with anaplastic transformation with the following findings: (1) highly cellular areas with large, atypical, pleomorphic cells in a necrotic and inflammatory background; (2) polygonal cells with nuclear grooves and pseudoinclusions arranged in papillary structures; and (3) large cells with vacuolated cytoplasm often containing mucinous material and smaller cells with epidermoidlike features. 6 The third case provides the findings obtained with FNA from a thyroid mass in patients with disseminated disease affecting the pleura and bones. Diagnosis was based on the identification of clusters of squamoid cells and intercellular deposits of lightly basophilic material, with the appearance of epithelial mucin.…”

Section: Discussionmentioning

confidence: 99%

“…5,8 Although its histology is well established, information regarding cytologic diagnosis by fine needle aspiration (FNA) is very scarce. 2,3,6,9,11 The aim of this paper is to describe the cytologic, histologic and immunohistochemical findings in a high grade MEC that evolved into an anaplastic carcinoma.…”

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confidence: 99%