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Atypical adenoma of the thyroid diagnosed as anaplastic cancer by cytopathology

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Title: Atypical adenoma of the thyroid diagnosed as anaplastic cancer by cytopathology
Authors: Hatakeyama, Hiromitsu Browse this author →KAKEN DB
Hoshino, Kimiko Browse this author
Mizoguchi, Kenji Browse this author
Suzuki, Takayoshi Browse this author
Hatanaka, Kanako C. Browse this author
Yamaya, Yukie Browse this author
Kano, Satoshi Browse this author →KAKEN DB
Mizumachi, Takatsugu Browse this author →KAKEN DB
Homma, Akihiro Browse this author →KAKEN DB
Keywords: anaplastic thyroid carcinoma
atypical adenoma
epithelial-mesenchymal transition
Issue Date: Oct-2017
Publisher: John Wiley & Sons
Journal Title: Diagnostic cytopathology
Volume: 45
Issue: 10
Start Page: 928
End Page: 933
Publisher DOI: 10.1002/dc.23751
PMID: 28544576
Abstract: Atypical adenoma of the thyroid is a rare form of tumor, and its accurate diagnosis prior to surgical resection is difficult as the histological and pathological morphologies are very similar to those of anaplastic thyroid carcinoma (ATC), and its anaplastic transformation remains to be elucidated. We reported a case of a 75-year-old female with a thyroid isthmus nodule diagnosed repeatedly by FNAC as anaplastic carcinoma. Both the first and second FNAC specimen slides showed a large number of scattered or aggregated atypical cells consisting of large, pleomorphic nuclei with irregular membranes, chromatin clumps and prominent nucleoli. The morphology of the surgical specimen was similar to that of an anaplastic carcinoma and although it showed signs of transition from a normal follicular epithelium, there was no invasive growth or mitosis. This lesion was diagnosed as an atypical adenoma, and a papillary carcinoma was also present in the right lobe of the thyroid. Here we evaluate the molecular features of atypical adenomas in comparison with 9 ATC samples, and discuss whether or not atypical adenomas represent a form of premalignant lesion. Ki-67 expression was found to be very low in atypical adenomas whereas all ATC samples showed high levels of Ki-67 expression. Epithelial-mesenchymal transition (EMT) marker expression suggested that atypical adenomas maintain their epithelial phenotype to a higher degree than do ATCs. Differential diagnosis between ATC and atypical adenoma is difficult by cytological and histological methods alone, and Ki-67 and EMT marker expression may support the diagnosis.
Rights: This is the peer reviewed version of the following article: Hatakeyama H, Hoshino K, Mizoguchi K, et al. Atypical adenoma of the thyroid diagnosed as anaplastic cancer by cytopathology. Diagnostic Cytopathology. 2017;45:928–933., which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 本間 明宏

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