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Carcinoma of the Thyroid With a Mixed Medullary, Papillary, Follicular, and Undifferentiated Pattern

Carcinoma of the Thyroid With a Mixed Medullary, Papillary, Follicular, and Undifferentiated Pattern Abstract • While papillary and follicular thyroid carcinomas are frequently mixed, this is a case of a medullary, papillary, follicular, and undifferentiated carcinoma of the same gland. In addition, all four tumor types were metastatic to regional lymph nodes. The patient described herein did not demonstrate features of the multiple endocrine neoplasia type 2 syndrome. Immunoperoxidase staining for calcitonin and thyroglobulin was positive in the follicular and medullary areas of tumor. Because the embryologic origin of the thyroidal follicular cells is from the endoderm and the origin of the parafollicular cells of the medullary carcinoma is from the ectodermal neural crest, this case seems noteworthy for demonstrating mixed metastatic tumor of composite embryologic origin. Alternatively, this case may represent an extension of what has recently been termed differentiated thyroid carcinoma, intermediate type by Ljungberg and co-workers. (Arch Intern Med 1985;145:1507-1509) References 1. DeGroot LJ: Thyroid carcinoma. Med Clin North Am 1975;59:1233-1245. 2. Valenta JL, Michel-Bechet M, Mattson JC, et al: Microfollicular thyroid carcinoma with amyloid rich stroma, resembling the medullary carcinoma of the thyroid (MCT). Cancer 1977;39:1573-1586.Crossref 3. Bussolait G, Monga G: Medullary carcinoma of the thyroid with atypical patterns. Cancer 1979;44:1769-1777.Crossref 4. Hales M, Rosenau W, Okerlund MD, et al: Carcinoma of the thyroid with a mixed medullary and follicular pattern. Cancer 1982;50:1352-1359.Crossref 5. Pollinck A, Freund U: Mixed papillary and follicular carcinoma of the thyroid gland with stromal amyloid. Am J Clin Pathol 1979;53:592-595. 6. Nieuwenhuizen Kruseman AC, Bosman FT, VanBergen H, et al: Medullary differentiation of anaplastic thyroid carcinoma. Am J Clin Pathol 1982;77:541-547. 7. Ljungberg 0, Ulla-Britt E, Bondeson L, et al: A compound follicular-parafollicular cells carcinoma of the thyroid: A new tumor entity? Cancer 1983;52:1053-1061.Crossref 8. Kameda Y, Harada T, Ito K, et al: Immunohistochemical study of the medullary thyroid carcinoma with references to C-thyroglobulin reaction of tumor cells. Cancer 1979;44:1071-1082.Crossref 9. DeLellis RA, Moore FM, Wolfe MJ: Thyroglobulin immunoreactivity in human medullary thyroid carcinoma, abstacted. Lab Invest 1983;48:20. 10. Kameda Y, Shigemoto H, Ikeda A: Development and cytodifferentiation of C cell complexes in dog fetal thyroids. Cell Tissue Res 1980;206: 403-409.Crossref 11. Calvert R, Isler H: Fine structure of a third epithelial component of the thyroid gland of the rat. Anat Rec 1979;168:23-31.Crossref 12. Ljundberg 0, Bondeson L, Bondeson A: Differentiated thyroid carcinoma, intermediate type: New tumor entity with features of follicular and parafollicular cell carcinoma. Hum Pathol 1984;15:218-228.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Carcinoma of the Thyroid With a Mixed Medullary, Papillary, Follicular, and Undifferentiated Pattern

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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1985.00360080189027
Publisher site
See Article on Publisher Site

Abstract

Abstract • While papillary and follicular thyroid carcinomas are frequently mixed, this is a case of a medullary, papillary, follicular, and undifferentiated carcinoma of the same gland. In addition, all four tumor types were metastatic to regional lymph nodes. The patient described herein did not demonstrate features of the multiple endocrine neoplasia type 2 syndrome. Immunoperoxidase staining for calcitonin and thyroglobulin was positive in the follicular and medullary areas of tumor. Because the embryologic origin of the thyroidal follicular cells is from the endoderm and the origin of the parafollicular cells of the medullary carcinoma is from the ectodermal neural crest, this case seems noteworthy for demonstrating mixed metastatic tumor of composite embryologic origin. Alternatively, this case may represent an extension of what has recently been termed differentiated thyroid carcinoma, intermediate type by Ljungberg and co-workers. (Arch Intern Med 1985;145:1507-1509) References 1. DeGroot LJ: Thyroid carcinoma. Med Clin North Am 1975;59:1233-1245. 2. Valenta JL, Michel-Bechet M, Mattson JC, et al: Microfollicular thyroid carcinoma with amyloid rich stroma, resembling the medullary carcinoma of the thyroid (MCT). Cancer 1977;39:1573-1586.Crossref 3. Bussolait G, Monga G: Medullary carcinoma of the thyroid with atypical patterns. Cancer 1979;44:1769-1777.Crossref 4. Hales M, Rosenau W, Okerlund MD, et al: Carcinoma of the thyroid with a mixed medullary and follicular pattern. Cancer 1982;50:1352-1359.Crossref 5. Pollinck A, Freund U: Mixed papillary and follicular carcinoma of the thyroid gland with stromal amyloid. Am J Clin Pathol 1979;53:592-595. 6. Nieuwenhuizen Kruseman AC, Bosman FT, VanBergen H, et al: Medullary differentiation of anaplastic thyroid carcinoma. Am J Clin Pathol 1982;77:541-547. 7. Ljungberg 0, Ulla-Britt E, Bondeson L, et al: A compound follicular-parafollicular cells carcinoma of the thyroid: A new tumor entity? Cancer 1983;52:1053-1061.Crossref 8. Kameda Y, Harada T, Ito K, et al: Immunohistochemical study of the medullary thyroid carcinoma with references to C-thyroglobulin reaction of tumor cells. Cancer 1979;44:1071-1082.Crossref 9. DeLellis RA, Moore FM, Wolfe MJ: Thyroglobulin immunoreactivity in human medullary thyroid carcinoma, abstacted. Lab Invest 1983;48:20. 10. Kameda Y, Shigemoto H, Ikeda A: Development and cytodifferentiation of C cell complexes in dog fetal thyroids. Cell Tissue Res 1980;206: 403-409.Crossref 11. Calvert R, Isler H: Fine structure of a third epithelial component of the thyroid gland of the rat. Anat Rec 1979;168:23-31.Crossref 12. Ljundberg 0, Bondeson L, Bondeson A: Differentiated thyroid carcinoma, intermediate type: New tumor entity with features of follicular and parafollicular cell carcinoma. Hum Pathol 1984;15:218-228.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1985

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