2007
DOI: 10.1002/dc.20579
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Fine‐needle aspiration biopsy of monophasic variant of spindle epithelial tumor with thymus‐like differentiation of the thyroid: Report of one case and review of the literature

Abstract: Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare biphasic tumor of the thyroid with approximately 20 well-documented cases reported in the English literature. Although a monophasic variant of SETTLE is conceivable, the majority of the reported cases were truly biphasic tumors. A minimal amount of epithelial component was present in the reported cases of so-called spindle-cell predominant SETTLE. Here, we report an apparently monophasic case of SETTLE in a 16-yr-old girl, in which no… Show more

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Cited by 35 publications
(42 citation statements)
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References 45 publications
(88 reference statements)
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“…[31][32][33] The cytological features include polygonal or spindle epithelial tumour cells, which are admixed with mature T-lymphocytes in variable proportion. 34 None of the thymic tumours shows immunohistochemical positivity of calcitonin. However, in cases with predominance of spindle cells and only scarce lymphocytes, medullary carcinoma should be also considered.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…[31][32][33] The cytological features include polygonal or spindle epithelial tumour cells, which are admixed with mature T-lymphocytes in variable proportion. 34 None of the thymic tumours shows immunohistochemical positivity of calcitonin. However, in cases with predominance of spindle cells and only scarce lymphocytes, medullary carcinoma should be also considered.…”
Section: Discussionmentioning
confidence: 99%
“…Thus, in ectopic cervical thymomas, the most important differential diagnosis is usually with malignant lymphoma. [29][30][31][32][33][34][35] In conclusion, paraganglioma-like medullary carcinoma of the thyroid gland is a rare but well characterized neoplasm. 33 SETTLE is usually presenting as a biphasic tumour composed of moderately cohesive spindle cells and large sheets of bland mucinous epithelial cells.…”
Section: Discussionmentioning
confidence: 99%
“…Some tumor cells may have eccentrically located nuclei and a plasmacytoid appearance. Neoplastic cells with similar cytologic features may been seen in other more common thyroid epithelial neoplasms such as papillary carcinoma, medullary carcinoma, or anaplastic carcinoma, as well as in uncommon epithelial tumors of the thyroid such as spindle epithelial tumor with thymus-like differentiation (SETTLE) 26,27 or carcinoma showing thymus-like differentiation (CASTLE). 28,29 Osteoid matrix is usually present in aspirates of osteosarcoma.…”
Section: Discussionmentioning
confidence: 95%
“…On cytologic examination, it may be difficult to differentiate osteoid matrix from the collagenous stroma occurring in many thyroid lesions. 27,30 In addition, osteoid may be mistaken as amyloid 31,32 or inspissated colloid 33,34 ; both may present as dense globules or fibrillary material. Special stains such as Congo red or electron microscopic examination may aid in the distinction.…”
Section: Discussionmentioning
confidence: 99%
“…Rare cases exhibit a predominantly monophasic pattern with spindle cell predominance [8,9]. Tong et al [10 ]reported a case of monophasic SETTLE in a 16-year-old girl in whom no epithelial cells were identified in either FNA biopsy or the subsequent hemithyroidectomy specimen. The following are synonyms for SETTLE: thyroid spindle cells tumor with mucinous cyst, malignant teratoma and thymoma of the thyroid gland [11,12].…”
Section: Discussionmentioning
confidence: 99%