Thyroid paraganglioma. Report of 3 cases and description of an immunohistochemical profile useful in the differential diagnosis with medullary thyroid carcinoma, based on complementary DNA array results

Esmeralda Castelblanco, Pilar Gallel, Susana Ros, Sonia Gatius, Joan Valls, Aguirre A. De-Cubas, Agnieszka Maliszewska, M. Teresa Yebra-Pimentel, Javier Menarguez, Carlos Gamallo, Giuseppe Opocher, Mercedes Robledo, Xavier Matias-Guiu

Research output: Contribution to journalArticlepeer-review

Abstract

Thyroid paraganglioma is a rare disorder that sometimes poses problems in differential diagnosis with medullary thyroid carcinoma. So far, differential diagnosis is solved with the help of some markers that are frequently expressed in medullary thyroid carcinoma (thyroid transcription factor 1, calcitonin, and carcinoembryonic antigen). However, some of these markers are not absolutely specific of medullary thyroid carcinoma and may be expressed in other tumors. Here we report 3 new cases of thyroid paraganglioma and describe our strategy to design a diagnostic immunohistochemical battery. First, we performed a comparative analysis of the expression profile of head and neck paragangliomas and medullary thyroid carcinoma, obtained after complementary DNA array analysis of 2 series of fresh-frozen samples of paragangliomas and medullary thyroid carcinoma, respectively. Seven biomarkers showing differential expression were selected (nicotinamide adenine dinucleotide dehydrogenase 1 alpha subcomplex, 4-like 2, NDUFA4L2; cytochrome c oxidase subunit IV isoform 2; vesicular monoamine transporter 2; calcitonin gene-related protein/calcitonin; carcinoembryonic antigen; and thyroid transcription factor 1) for immunohistochemical analysis. Two tissue microarrays were constructed from 2 different series of paraffin-embedded samples of paragangliomas and medullary thyroid carcinoma. We provide a classifying rule for differential diagnosis that combines negativity or low staining for calcitonin gene-related protein (histologic score,

Original languageEnglish
Pages (from-to)1103-1112
Number of pages10
JournalHuman Pathology
Volume43
Issue number7
DOIs
Publication statusPublished - Jul 2012

Keywords

  • cDNA arrays
  • Differential diagnosis
  • Immunohistochemistry
  • Medullary thyroid carcinoma
  • Thyroid paraganglioma
  • Tissue microarray

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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