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 language | English |
|---|---|
| Pages (from-to) | 705-722 |
| Number of pages | 18 |
| Journal | American Journal of Surgical Pathology |
| Volume | 9 |
| Issue number | 10 |
| Publication status | Published - 1985 |
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ASJC Scopus subject areas
- Anatomy
- Pathology and Forensic Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Clear cell change in primary thyroid tumors. A study of 38 cases
AU - Carcangiu, M. L.
AU - Sibley, R. K.
AU - Rosai, J.
PY - 1985
Y1 - 1985
N2 - 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.
AB - 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.
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UR - http://www.scopus.com/inward/citedby.url?scp=0022358665&partnerID=8YFLogxK
M3 - Article
C2 - 4061729
AN - SCOPUS:0022358665
VL - 9
SP - 705
EP - 722
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
SN - 0147-5185
IS - 10
ER -