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Pseudoangiosarcomatous features in medullary thyroid carcinoma spindle‐cell variant. Report of a case studied by FNA and immunohistochemistry
Author(s) -
Laforga Juan B.,
Aranda F. Ignacio
Publication year - 2007
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.20656
Subject(s) - angiosarcoma , pathology , cytokeratin , medicine , thyroid , cd34 , immunohistochemistry , medullary carcinoma , sarcoma , hemangiosarcoma , hyaline , eosinophilic , thyroid carcinoma , anatomy , biology , stem cell , genetics
Abstract We report a case of medullary thyroid carcinoma (MTC), spindle cell variant, which exhibited striking histological pseudovascular clefts and abortive lumina, closely mimicking an angiosarcoma. The patient is a 72‐yr‐old‐man who presented facial rash and a solid nodule in the right lobe of the thyroid gland. The fine‐needle aspiration (FNA) showed bloody background containing loosely groups of fusiform and plasmocytoid cells with coarse chromatin and eosinophilic granular cytoplasms. Microscopically, the tumor exhibited spindle‐cell pattern intermingled with a striking angiosarcoma‐like pattern characterized by the presence of abortive lumen and clefts containing erythrocytes. Dense hyaline extracellular amyloid was present. The tumor cells were strongly positive for cytokeratin, chromogranine‐A, synaptophysine, serotonin, calcitonin, and CEA. TTF‐1 was weakly positive. Stains for CD34 and CD31 were negative. This case illustrates that the spindle cell variant of MTC may exhibit an infrequent angiosarcoma‐like appearance which may be misdiagnosed as angiosarcoma. Diagn. Cytopathol. 2007;35:424‐428. © 2007 Wiley‐Liss, Inc.