Clear cell change in primary thyroid tumors. A study of 38 cases

M. L. Carcangiu, R. K. Sibley, J. Rosai

Research output: Contribution to journalArticle

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Abstract

Thirty-eight primary thyroid neoplasms with extensive (≥50%) clear cell changes were studied. These were divided into four categories: 1) Hurthle cell tumors, 10 cases; 2) follicular tumors, 17 cases (two of them having a signetring or lipoblast-like appearance); 3) papillary carcinomas, seven cases; and 4) undifferentiated carcinomas, four cases. These were compared with eight cases of renal cell carcinoma metastatic to the thyroid. Factors resulting in the cytoplasmic clear cell changes were: 1) formation of medium-sized vesicles, many of apparent mitochondrial derivation; 2) accumulation of glycogen (with or without accompanying fat); and 3) deposition of intracellular thyroglobulin. Vesicle formation was the most common cause of clear cell change in Hurthle cell and follicular tumors; glycogen accumulation in papillary, undifferentiated, and metastatic tumors; and thyroglobulin deposition in the subgroup of follicular tumors with a signet-ring or lipoblast-like appearance. However, several exceptions were noted. The results of this study refute the commonly held belief that all thyroid tumors containing clear cells are malignant, and do not support the concept of 'clear cell carcinoma' of the thyroid as a specific microscopic entity. We believe that the natural history of thyroid tumors containing clear cells is more dependent on their basic cytoarchitectural features than on the presence, amount, or type of clear cells, and we suggest for these tumors to be evaluated for carcinoma by using standard morphologic criteria for their respective types. The importance of thyroglobulin staining for the differential diagnosis with metastatic renal cell carcinoma is emphasized, but the pitfalls inherent to this technique are also pointed out.

Original languageEnglish
Pages (from-to)705-722
Number of pages18
JournalAmerican Journal of Surgical Pathology
Volume9
Issue number10
Publication statusPublished - 1985

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Thyroid Gland
Thyroglobulin
Neoplasms
Oxyphilic Adenoma
Glycogen
Thyroid Neoplasms
Renal Cell Carcinoma
Carcinoma
Papillary Carcinoma
Natural History
Differential Diagnosis
Fats
Staining and Labeling

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Carcangiu, M. L., Sibley, R. K., & Rosai, J. (1985). Clear cell change in primary thyroid tumors. A study of 38 cases. American Journal of Surgical Pathology, 9(10), 705-722.

Clear cell change in primary thyroid tumors. A study of 38 cases. / Carcangiu, M. L.; Sibley, R. K.; Rosai, J.

In: American Journal of Surgical Pathology, Vol. 9, No. 10, 1985, p. 705-722.

Research output: Contribution to journalArticle

Carcangiu, ML, Sibley, RK & Rosai, J 1985, 'Clear cell change in primary thyroid tumors. A study of 38 cases', American Journal of Surgical Pathology, vol. 9, no. 10, pp. 705-722.
Carcangiu, M. L. ; Sibley, R. K. ; Rosai, J. / Clear cell change in primary thyroid tumors. A study of 38 cases. In: American Journal of Surgical Pathology. 1985 ; Vol. 9, No. 10. pp. 705-722.
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