Diffuse sclerosing papillary carcinoma of the thyroid gland: immunohistochemical analysis of the local host immune response

Abstract

Surgical specimens from four patients with diffuse sclerosing papillary carcinoma of thyroid were examined by electronmicroscopy. In addition, immunohistochemical examination using a panel of monoclonal and polyclonal antibodies was carried out in order to investigate the expression of HLA-DR antigen, the presence of Langerhans' cells and the phenotypic characteristics of the inflammatory infiltrate. The ultrastructural study showed that the intraglandular dissemination, typical of this tumour, was due to massive lymphatic invasion. Many Langerhans' cells were observed among tumour cells and in the lymphoid infiltrates in proximity to tumour foci. HLA-DR expression was seen on macrophages, Langerhans' cells, endothelial cells, lymphoid cells, many tumour cells and in some non-neoplastic follicles close to tumour clusters and lymphoid infiltrates. The immunohistochemical analysis of the inflammatory infiltrates showed a high proportion of B- and T-cells, and moderate numbers of plasma cells. Our results suggest that the tumour-specific immune response can give rise to an autoimmune reaction involving non-neoplastic follicles. It is suggested that this could be one of the mechanisms responsible for immunofacilitation of tumour growth.

Morules in cribriform‐morular variant of papillary thyroid carcinoma: Immunohistochemical characteristics and distinction from squamous metaplasia

“…Dendritic cells, antigen‐presenting cells, are also observed in papillary thyroid carcinoma and the dense infiltrate suggests a more favorable prognosis (27). Chronic inflammatory reaction and abundant dendritic cells are characteristic of DSV (9, 10). We observed that dendritic cells were not only present in the stroma, but also between conventional carcinoma cells and within squamous metaplastic nests.…”

Oncocytic papillary carcinoma with lymphoid stroma (Warthin‐like tumour) of the thyroid: a distinct entity with favourable prognosis

“…Several morphologic variants of PC have been described, some of them having a less favourable prognosis (e.g. tall‐cell PC, columnar cell PC, and diffuse sclerosing PC) than the ‘classical’ variant 17–29 . The oncocytic (oxyphilic, Hürthle cell) variant of thyroid PC represents a relatively unusual neoplasm, and its clinicopathological features and biological behaviour have not yet been fully characterized.…”

“…tall-cell PC, columnar cell PC, and diffuse sclerosing PC) than the 'classical' variant. [17][18][19][20][21][22][23][24][25][26][27][28][29] The oncocytic (oxyphilic, Hü rthle cell) variant of thyroid PC represents a relatively unusual neoplasm, and its clinicopathological features and biological behaviour have not yet been fully characterized. This tumour accounts for 1-11% of all cases of thyroid PC; the differences among reported series probably result from application of different classification criteria.…”

Cytomorphologic Features of Diffuse Sclerosing Variant of Papillary Carcinoma of the Thyroid

“…An association between thyroiditis and DSPC has been postulated. 5,[10][11][12] Therefore, the possibility of double pathology may have to be considered. Both our cases showed characteristic features of papillary carcinoma; therefore, the diagnosis was not difficult.…”