1/37. A peculiar factor viii-related antigen staining of an oxyphilic cell nodule within an intrathyroidal parathyroid adenoma.A case of intrathyroidal parathyroid adenoma, which was found in the lower portion of the right thyroid lobe, is presented. The nodule in this lesion was composed of oxyphilic cells. In order to verify a possible vascular invasion, immunohistochemical study with factor viii-related antigen/von willebrand factor, which is known to be synthesized by the endothelial cells and stored in weibel-palade bodies, and ulex europaeus lectin 1 were applied. It was interesting to find positivity for factor viii-related antigen and ulex europaeus lectin I strictly confined in the nodule of oxyphil cells, which are known to have large numbers of mitochondria. This led to investigating similar immunoreactions in different lesions of oxyphilic cells with several other markers. The possible cross-reaction between weibel-palade bodies and mitochondria deserves further detailed research.- - - - - - - - - - ranking = 1keywords = adenoma (Clic here for more details about this article) |
2/37. Hurthle cell adenoma of the mediastinum: intraoperative cytology and differential diagnosis with correlative gross, histology, and ancillary studies.A 66-year-old man was found to have a 7.5 cm mediastinal mass detected on routine chest x-rays as part of his preoperative work up for an inguinal hernia repair. An orthotopic (normally located) nongoitrous thyroid gland without evidence of connection to the mediastinal mass was also identified. The clinical differential diagnoses included lymphoma, thymoma, and germ cell tumor. Fine-needle aspiration (FNA) biopsy smears and touch imprints of the mediastinal mass showed a loosely cohesive, highly cellular population of relatively uniform cells with abundant granular cytoplasm, low nuclear to cytoplasmic (N/C) ratios, and prominent nucleoli consistent with a Hurthle cell (HC) neoplasm. Subsequently, the diagnosis of HC adenoma was confirmed on the surgically excised mediastinal mass. To the best of our knowledge, the surgical pathology and cytologic features of an HC adenoma of the mediastinum have not been reported in the literature. The gross, histologic, immunohistochemical, and electron microscopic (EM) findings, in addition to the cytologic features, are presented along with a differential diagnosis of this mediastinal neoplasm.- - - - - - - - - - ranking = 1.2keywords = adenoma (Clic here for more details about this article) |
3/37. Unusual complication of total thyroidectomy: arteriovenous fistula.We describe the case of a 29-year-old woman from the Chernobyl area, who moved to the czech republic 10 years after the Chernobyl nuclear disaster. She was evaluated for a large goiter. Fine-needle aspiration cytology indicated a diagnosis of a typical degenerated Hurthle cell adenoma. She underwent total thyroidectomy but a continual loud murmur was found 1 month after surgery. An arteriovenous (AV) fistula between the right thyrocervical trunk and the right jugular vein was proven angiographically. This fistula was successfully closed by artificial embolization performed by detachable Gianturco-Anderson-Wallace (GAW) coil. This is the first description of using such a procedure in order to close an AV fistula after thyroidectomy.- - - - - - - - - - ranking = 0.2keywords = adenoma (Clic here for more details about this article) |
4/37. Hurthle cell adenoma diagnosed by core needle biopsy in a male patient.Hurthle cell adenomas (HCAs) are a rare and potentially lethal variant of follicular tumors of the thyroid. Considerable controversy exists regarding potential risk factors, diagnosis, and treatment of HCAs. The authors report the case of a 38-year-old male patient with an 8.3 cm x 3.5 cm HCA. diagnosis was made preoperatively from a core needle biopsy and confirmed postoperatively on frozen section. Treatment consisted of a right lobectomy.- - - - - - - - - - ranking = 1keywords = adenoma (Clic here for more details about this article) |
5/37. Oncocytic cystadenoma of the parotid gland with tyrosine-rich crystals.A case of benign oncocytic cystadenoma with abundant intraluminal tyrosine-rich crystals involving the parotid gland is described.- - - - - - - - - - ranking = 1keywords = adenoma (Clic here for more details about this article) |
6/37. phyllodes tumor metastatic to thyroid Hurthle cell adenoma.We present a case of a malignant phyllodes tumor metastasizing to a Hurthle cell adenoma of the thyroid. A 55-year-old woman underwent mastectomy for a malignant phyllodes tumor. Two years later, she presented with a left thyroid mass, which was a single, circumscribed, soft, deep red-brown nodular lesion with an eccentric area of firmer consistency. Histologically, the thyroid tumor was composed of 2 distinct types of cellular proliferation. Atypical spindle cells were infiltrating between the Hurthle cell cords and follicles in a fibrosarcomatous pattern. A battery of immunohistochemical stains was applied to both the thyroid and breast tumors for comparison. Based on the histologic and immunophenotypic features of the fibrosarcomatous components of both the breast and thyroid tumors, we rendered a diagnosis of cystosarcoma phyllodes metastatic to Hurthle cell adenoma. To the best of our knowledge, this unusual case is a first report of tumor-to-tumor metastasis of a sarcoma to a primary thyroid neoplasm.- - - - - - - - - - ranking = 1.2keywords = adenoma (Clic here for more details about this article) |
7/37. Cribriform-morular variant of papillary carcinoma: the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma. A case report with clinical and molecular genetic correlation.The increased incidence of thyroid carcinomas in familial adenomatous polyposis (FAP) patients is well recognised. These thyroid neoplasms display distinctive clinicopathological features and generally show good prognostic outcome. Recently, unusual sporadic tumours that share the morphological features of FAP-associated thyroid carcinomas have also been described. In this report, we document a case of a thyroid tumour in a previously well, 46-year-old female. histology revealed a circumscribed neoplasm composed of tubular, papillary, cribriform and solid areas. The pseudostratified columnar tumour cells showed occasional nuclear grooves and rare nuclear inclusions. immunohistochemistry showed positive staining with antibodies to cytokeratin AE1/AE3, oestrogen and progesterone receptor proteins. Focal immunoreactivity was also noted with antibodies to thyroglobulin, epithelial membrane antigen, 34betaE12 and cytokeratin CK7. The absence of polyps on colonoscopy and germline mutation in the adenomatous polyposis coli (APC) gene provides evidence that this tumour represents the sporadic counterpart of FAP-associated thyroid carcinoma. The patient is well with no evidence of disease 7 months following resection of the tumour. The differential diagnoses and molecular genetics of this unusual tumour are discussed.- - - - - - - - - - ranking = 1.2keywords = adenoma (Clic here for more details about this article) |
8/37. Oncocytic parathyroid adenoma: problem in cytological diagnosis.Parathyroid lesions, which may occur within the thyroid, may clinically simulate thyroid nodules. Fine-needle aspiration (FNA) of these presumably "thyroid nodules" can lead to misinterpretation of cytomorphological findings because of similarities in cytological features of neoplastic and nonneoplastic parathyroid and thyroid lesions. This might be true especially for oncocytic parathyroid adenomas and parathyroid adenomas with prominent oncocytic component that, although rare, tend to be large and often are associated with minimal hyperparathyroidism. We report two cases of this type of clinically "silent" parathyroid adenomas that on FNA were diagnosed as Hurthle cell thyroid neoplasm.- - - - - - - - - - ranking = 1.4keywords = adenoma (Clic here for more details about this article) |
9/37. Renal cell carcinoma metastatic to Hurthle cell adenoma of thyroid.Metastases to the thyroid gland are a common finding at autopsy in patients who died of malignancy and are often misdiagnosed as primary thyroid neoplasms clinically. We present a patient with a rare, unusual case of renal cell carcinoma (RCC) metastatic to a Hurthle cell adenoma of the thyroid. A 53-year-old woman was admitted to a University of texas Medical Branch Hospital (Galveston, TX) for a large right thyroid mass that was present for 3 months. A fine needle aspiration of the thyroid mass was performed and interpreted as suggestive of a Hurthle cell neoplasm. A total thyroidectomy revealed Hurthle cell adenoma containing clusters of cytologically atypical cells with clear cytoplasm. Subsequent patient evaluation and computed tomography revealed a renal mass. Left radical nephrectomy was performed at a later date for left renal mass and the microscopic examination confirmed the diagnosis of primary clear cell carcinoma of the kidney. Further studies confirmed that the thyroid mass was metastases from RCC. Although carcinoma of the kidney is responsible in most instances of metastatic disease to the thyroid, metastatic RCC to a thyroid neoplasm is extremely rare, with only two reports found in the English literature. The possibility of metastatic RCC should always be taken under consideration, especially when nests of clear cells are seen infiltrating into the thyroid parenchyma or neoplasm.- - - - - - - - - - ranking = 1.2keywords = adenoma (Clic here for more details about this article) |
10/37. Oxyphil parathyroid adenoma: a malignant presentation of a benign disease.Functioning parathyroid adenomas of the oxyphil cell type are rare, and the clinical characteristics of patients with these tumors have not been well defined. We describe two cases of severe primary hyperparathyroidism (PHPT) caused by benign oxyphil parathyroid adenomas. The patients' clinical presentations mimicked parathyroid carcinoma. Both had very large tumors associated with marked elevations in PTH and serum calcium levels. Skeletal manifestations were also atypical for benign PHPT, with severe osteoporosis in one patient and osteitis fibrosa cystica in the other. These cases also highlight the remarkable capacity of the skeleton to recover after successful parathyroidectomy, previously reported in other forms of severe PHPT. Bone mineral density improved dramatically 1 yr after parathyroidectomy, with increases of 51% at the lumbar spine, 36% at the total hip, and 11% at the distal one third radius. Most of the increases occurred in the first postoperative months. Consistent with this early and accelerated skeletal response, markers of bone turnover were increased 2 months after surgery and normalized by 8 months postoperatively. In patients with PHPT who present with severe or atypical clinical features, oxyphil adenoma should be considered.- - - - - - - - - - ranking = 1.4keywords = adenoma (Clic here for more details about this article) |
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