Dedifferentiated solid variant papillary thyroid carcinoma with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: a case report with pathological characteristics and literature analysis

doi:10.16150/j.1671-2870.2019.05.012

Abstract

Abstract:

Objective: To report the clinical manifestation, ultrasonographic imaging (US) feature and pathological feature of a rare case of dedifferentiated solid variant papillary thyroid carcinoma (SVPTC) with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) and to discuss its pathological characteristics. Method: The clinical data, imaging feature and pathologic feature of this rare case were analyzed, and the characteristics of SVPTC, dedifferentiation and MALT were discussed separately. Result: The thyroid tissue was grossly grayish-white in color, and the microscopic examination showed that the tumor cells were arranged in a solid, nested shape, and the mitotic figures were easy to see; no typi-cal nuclear features of papillary carcinoma were seen; the interstitial was composed of small lymphocytes with different forms. Some Russell bodies could be seen. IHC showed CK19(+), Ki67 (80%+), TG(-), TTF-1(+), Bcl-6(+),CK5/6（-）,CD117（-）;peripheral lymphocytes: CD20(+), CD79α(+), CD3 (+), CD5(+), CD43(+), Bcl-2(+). Molecular pathology showed that no mutations were detected in BRAF but mutations in TERT promoter were detected.B lymphoma clone gene rearrangement was positive. The final pathological diagnosis was dedifferentiated SVPTC with MALT. Conclusions: Dedifferentiated SVPTC with MALT is extremely rare and has poor prognosis. Each feature deserves careful documentation and discussion.

Key words: Thyroid Neoplasms, Carcinoma, Papillary, Cell Dedifferentiation, Lymphoma

CLC Number:

R736.1

YANG Zhifang, FANG Guoping, ZHAN Weiwei, JI Ri. Dedifferentiated solid variant papillary thyroid carcinoma with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: a case report with pathological characteristics and literature analysis[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(05): 548-554.

Figures/Tables 6

References 25

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