Multifocal papillary carcinoma of the thyroid with heterotopic ossification and extramedullary hematopoiesis associated with a lipomatous follicular nodule

Heterotopic ossification has been described in papillary thyroid carcinoma in association with high incidence of extrathyroidal invasion, multifocality, lymph node metastasis, and older age. Nevertheless, it has not been described as a specific subtype of papillary thyroid carcinoma, because of its rarity. We described the case of an 80-year-old female patient, with familial history of papillary thyroid carcinoma. In the annual screening examination, she was diagnosed with thyroid nodules. The patient was submitted to a thyroidectomy because the fine needle aspiration cytology was positive for malignancy according to the Bethesda classification. The surgical specimen analyses showed a multifocal papillary carcinoma with one major lesion in the left lobe measuring 0.9 cm, and two small lesions (0.4 cm and 0.2 cm) in the right lobe. Only the biggest lesion in the right lobe had the osteoid matrix with rare osteoclasts and fat metaplasia with progenitor cells. There was perineural invasion, but vascular invasion was not identified. The margins were free and there was no extrathyroidal extension. In the left lobe there was an oncocytic nodule and a lipomatous follicular nodule. In recent years there has been a significant increase in the diagnosis of thyroid cancer, mainly because of the finding of microcarcinomas as a result of many requests for cervical image exams. Future studies may define (i) whether papillary thyroid carcinoma with heterotopic ossification is a true histological variant; (ii) the causes of that alteration; and (iii) eventual follow-up implications.

Avaliação da diluição do DNA extraído de material parafinado para amplificação em PCR / Evaluation of DNA dilution extracted of paraffin-embedded material for PCR amplification

Introdução: Alguns fatores, como a presença de substâncias inibidoras e degradação do DNA, podem contribuir para a falha na detecção de genes, através da reação em cadeia da polimerase (PCR), a partir de DNA extraído de material parafinado. A diluição do DNA frequentemente pode reduzir o número de inibidores e contaminantes e ainda assim conter DNA suficiente para a amplificação em PCR. Objetivo: Avaliar a influência da diluição de soluções de DNA extraído de material parafinado na amplificação por PCR do gene ß-globina humana. Material e método: Foram utilizados 30 blocos parafinados de carcinomas epidermoides de orofaringe referentes a pacientes diagnosticados e tratados no Centro de Oncologia Bucal da FOA-UNESP. A extração do DNA foi realizada com o sistema QIAamp DNA minikit (Quiagen). O DNA obtido foi quantificado e avaliado quanto à pureza por espectrofotometria. Dois grupos foram formados com diferentes quantidades de DNA, sendo que o Grupo I foi constituído pelo DNA originalmente extraído e o Grupo II com o mesmo DNA , porém diluído com adição de água ultrapura.

Foi realizada a PCR utilizando-se oligonucleotídeos iniciadores para ß-globina. Resultados: No grupo I, 33,33% das amostras foram positivas para o gene ß-globina, enquanto no Grupo II, 23,33% foram positivas. Conclusão: Neste estudo, a diluição do DNA extraído de material parafinado não alterou estatisticamente a quantidade de amostras positivas por PCR para o gene ß-globina, embora os resultados obtidos sugiram que esta seja uma das formas de aumentar a eficácia do método de amplificação por PCR

Correlation between koilocytes and human papillomavirus detection by PCR in oral and oropharynx squamous cell carcinoma biopsies

The purpose of this study was to compare the histopathological analysis with polymerase chain reaction (PCR) methods to predict the presence of human papillomavirus (HPV) infection in oral squamous cell carcinoma biopsies. Eighty-three paraffin-embedded tissue specimens from patients with oropharynx and mouth floor squamous cell carcinoma were submitted to histopathological analysis under light microscopy, specifically for the determination of the presence of koilocytes. Subsequently, DNA was purified from the same paraffin-embedded specimens and submitted to PCR. Fisher's exact test showed no statistically significant correlation between the two methods. The results suggest that the presence of koilocytes is unreliable for the detection of HPV presence in oral and oropharynx squamous cell carcinoma.

Human papillomavirus (HPV) detection in lip squamous cell carcinoma: correlation with clinical aspects and risk factors / Detecção do papilomavírus humano (HPV) em carcinoma espinocelular de lábio: correlação com aspectos clínicos e fatores de risco

O papilomavírus humano (HPV) está associado a um largo espectro de lesões em humanos e tem sido ligado à carcinogênese oral. O objetivo deste estudo foi investigar a presença do DNA do HPV em pacientes com carcinoma espinocelular de lábio e correlacioná-la com aspectos clínicos e fatores de risco. Foram estudados 33 pacientes com carcinoma espinocelular de lábio. Destes, 30 pacientes foram positivos para o gene da beta-globina humana e então foram testados para o DNA do HPV com uso da reação em cadeia de polimerase em duas etapas (PCR e nPCR) com os oligonucleotídeos iniciadores MY11/MY09 e GP5+/ GP6+. O DNA do HPV foi detectado em 43,33 por cento dos 30 pacientes analisados. Não houve associação com os fatores de risco analisados.

Human papillomavirus (HPV) is associated with a wide spectrum of lesions in humans, and it has been linked to oral carcinogenesis. The aim of this study was to investigate the presence of HPV DNA in patients with lip squamous cell carcinoma and to correlate it with clinical characteristics and risk factors. We studied 33 patients with lip squamous cell carcinomas. Of these, 30 were positive for human beta globin gene and tested for HPV DNA, using polymerase chain reaction in two steps (PCR and nPCR) with MY11/MY09 and GP5+/GP6+ primers. HPV DNA was detected in 43.33% of patients analyzed. There was no association with the risk factors analyzed.