Case 21

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Revision as of 03:32, 30 January 2014 by Michael (talk | contribs) (→‎Diagnosis: more)
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Provided clinical history

34 year old woman, thyroid mass

Site

Thyroid gland

Primary image

Medullary thyroid carcinoma - low mag.jpg
Low magnification. H&E stain.
Medullary thyroid carcinoma - 2 - intermed mag.jpg
Low magnification. H&E stain.
High magnification 
Medullary thyroid carcinoma - high mag.jpg
High magnification. H&E stain.
Very high magnification 
Medullary thyroid carcinoma - 2 - very high mag.jpg
Very high magnification. H&E stain.

Differential diagnosis

Differential diagnosis 
anaplastic carcinoma, medullary thyroid carcinoma

Additional tests

More history

More history 
Serum calcitonin elevated. Brother had a pheochromocytoma.

Ask a colleague

Ask a colleague 
Looks like it isn't going to be papillary this time!

Stains

Alcian blue/PAS to Bilirubin
Test Result
Alcian blue/PAS
Alican blue pH 1.0
Alcian blue pH 2.5
Auramine
Bielchowsky
Bilirubin
Colloidal iron to Fontana-Masson
Test Result
Colloidal iron
Congo red
Cresyl violet
Dieterle
Diff Quik
Fontana-Masson
Gallyas to Gremelius
Test Result
Gallyas
Giemsa
GMS
Gomori's trichrome
Gram
Gremelius
JMS to Mucicarmine
Test Result
JMS
Jones
Kinyoun
Luxol fast blue
Masson trichrome
M-MAS
Movat
Mucicarmine
Oil red O to Prussian blue
Test Result
Oil red O
Orecein
PAS
PASD
PASF
PTAH
Prussian blue
Reticulin to Ziehl-Neelsen
Test Result
Reticulin
Sudan black B
Toluidine blue
Verhoeff
Von Kossa
Warthin-Starry
Ziehl-Neeslen

IHC

Alpha-1 AT to Cathepsin K
Test Result
alpha-1 AT
ACTH
AE1/AE1
alpha-fetoprotein
Alk-I
AMACR
AR
ATRX
Beta2-microglobulin
B72.3
Beta-catenin
BCL2
BCL6
BCLxL
C3 comp
CA9
Calcitonin
Calponin
Calretinin
CAM5.2
Cathepsin K
CD10 to Chromogranin
Test Result
CD10
CD117
CD138
CD15
CD1a
CD20
CD21
CD23
CD3
CD30
CD31
CD34
CD35
CD4
CD43
CD45 (LCA)
CD5
CD56
CD57
CD68
CD7
CD79a
CD8
CD99
CDX2
CEA-m
Chromogranin
CK17 to Glypican 3
Test Result
CK17
CK19
CK20
CK34betaE12
CK5/6
CK7
CMV
c-MYC
Cyclin D1
D2-40
Desmin
DOG1
EBV
EMA
ER and PR
Factor VIII
Factor XIIIa
Fascin
FH
FSH
Gastrin
GATA3
GCDFP-15 (BRST2)
GFAP
GH
Glucagon
Glypican-3
HBME-1 to IgM
Test Result
HBME-1
HBV core
HBV surface
H-caldesmon
HCG
Helicobacter
Hepatocyte
HER2/neu
HHV-8
HMB-45
HNF1beta
HPV
HSV-I
HSV-II
IDH-1
Inhibin
INI1 (BAF47)
Insulin
Kappa
Ki-67
Lambda
Leu 7
IgA
IgG
IgM
LH to PDGFR
Test Result
LH
LIN28
Lysozyme
mammoglobin
MAP2
MCV
Melanin A
MHC class I
MITF
MUM1
Myeloperoxidase
MYO D1
Myoglobin
Napsin
NF
NKX3.1
NSE
OCT3/4
p16
P501S
p53
p57
p63
Pankeratin
PAX2
PAX5
PAX8
PCNA
PDGFR
PLAP to WT1
Test Result
PLAP
PNL-2C
Prolactin
PSA
PSAP
RCC
S-100
SALL4
Smooth muscle actin
Somatostatin
STAT6
Synaptophysin
TdT
TFE3
TFEB
Thyroglobulin
Toxoplasma
TSH
TTF-1
Ubiquitin
UCHL1 (PGP9.5)
Ulex Europaeus
Vimentin
VIP
VZV
WT-1

Chromosomal translocations

Translocations Chr 1-10
Test Result
t(1;13) PAX7-FKHR
t(2,13) PAX3-FKHR
t(8;14) MYC-IGH
t(9;22) BCR-ABL
t(9;22) CHN-EWS
Translocations Chr 11-13
Test Result
t(11;14) CCND1-IGH
t(11;22) EWS-WT1
t(11;22) FLI1-EWS
t(12;15) ETV6-NTRK3
t(12;16) FUS-ATF1
t(12;16) CHOP-TLS
t(12;22) EWS-ATF1
Translocations Chr 14-22
Test Result
t(14,18) IGH-BCL2
t(15;17) PML-RARA
t(16;21) FUS-ERG
t(17;22) COLA1-PDGFB
t(21;22) EWS-ERG
Translocations Chr X & Y
Test Result
t(X;1) PRCC-TFE3
t(X;17) TFE3-ASPL
t(X;18) SYT-SSX

Diagnosis

Diagnosis 
Medullary thyroid carcinoma


Comment: The possibly of MEN IIa syndrome or MEN IIb syndrome should be considered.


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