Papillary Carcinoma Thyroid Variants and Immunomarker Expression - An Additional Diagnostic tool
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
The incidence of thyroid cancers is on the rise during the recent years with 80% of thyroid malignancies constituted by papillary carcinoma thyroid. The histopathological diagnosis of papillary carcinoma thyroid is easier in typical cases. The two commonly used markers cytokeratin 19 and HBME1(Hector Battifora mesothelial 1) can be of great help in grey areas where H&E diagnosis is challenging. A total of 30 cases diagnosed as papillary carcinoma thyroid were included in the study. Most common variant observed in this study was the classical variant (19 cases, 63.33%). Scoring of CK 19 expression based on the percentage of positively stained cells was done. The classical variant showed 4+ positivity in 16 cases (84.21%), 3 + positivity in 2 cases (10.52%) and 2 + positivity in 1 case (5.26%). In the follicular variant 3 cases (50%) showed 4 + positivity, 2 cases ( 33.33%) showed 3 + positivity and only 1 case (16.6%) showed 2 + positivity. The columnar cell variant showed 3 + positivity. All other variants showed 4 + positivity. In nonneoplastic areas pseudopapillary foci were either negative or weakly positive . HBME-1 showed 4+ positivity in 11 cases(57.89%) of classical variant, 3+ positivity in 3 cases(15.78%) and 2+ positivity in 4 cases (21.05%). In the follicular variant, 1 case (16.66%) showed 2+ positivity,1 case (16.66%) showed 3+ positivity and 3 cases (50%) showed 4+ positivity. The intracystic variant showed 3+ positivity in 1 case and 2+ positivity in 1 case. All other variants showed 4+ positivity. Associated benign lesions did not show HBME-1 expression. Among the variants both the markers showed positive staining . Therefore, a combined immunostaining with CK19 and HBME1 increases the diagnostic accuracy in papillary thyroid carcinoma.
Authors and Affiliations
Dr. Sithy Athiya Munavarah, Dr. Hemalatha, Dr. Suresh Durai J, Dr. Johnsy Merla J, Dr. Chandru Mari, Dr. Shantaraman K
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