ABSTRACT
@#A 23-year-old woman underwent left thyroid lobectomy and isthmusectomy for a 2 cm diameter firm mass on the left side of the neck that was also visualized on ultrasonography. The specimen consisted of a 22-gram thyroid gland composed of the left lobe, isthmus and a pyramidal lobe. Cut section of the left lobe showed a 3.5 cm diameter solitary, discrete and encapsulated mass with a tan lobulated and solid cut surface. The rest of the thyroid tissues had red-brown meaty cut surfaces. Microscopic section shows a follicular-patterned proliferation enclosed by a thin fibrous capsule with frequent Sanderson polster-like papillary excrescences. (Figures 1 and 2) Both the follicular and the papillary structures are lined by cuboidal to columnar follicular epithelial cells that had ample eosinophilic to pale cytoplasm and uniformly sized, minimally enlarged, generally round, and monolayered nuclei without nuclear grooving, folds, pseudoinclusions, and chromatin clearing. There are no mitotic figures seen. Some of the papillary structures have delicate vascular cores. (Figure 3) There are no psammoma bodies noted. The follicles contain variable amounts of pale eosinophilic colloid ranging from colloid-poor crowded follicles to those with ample colloid that have frequent peripheral scalloping. (Figure 4) Exhaustive sections failed to disclose capsular or vascular invasion. Based on the microscopic features, a diagnosis of follicular adenoma with papillary architecture was rendered.
Subject(s)
Adenocarcinoma, Follicular , Thyroid Cancer, PapillaryABSTRACT
Objective:To analyze the clinicopathological features, survival and related prognostic factors of encapsulated papillary carcinoma (EPC) of breast.Methods:Data on EPC and invasive ductal carcinoma (IDC) of the breast from January 2010 to December 2015 were searched and screened using the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to adjust for baseline confounding between the EPC and IDC groups. The Kaplan-Meier method was used to calculate cumulative survival curves for overall survival (OS) and breast cancer-specific survival (BCSS). Prognostic value of these factors were assessed by univariate Log-rank test and multivariate Cox regression analysis.Results:In this study, 184 524 patients with IDC and 175 patients with EPC were included. Compared with patients with IDC, patients with EPC over 60 years old had a higher proportion, a lower rate of lymph node metastasis, and a higher proportion of estrogen receptor positive, progesterone receptor positive and human epidermal growth factor receptor 2 negative ( P<0.05). After PSM adjustment, OS of patients with EPC was worse than that of IDC, and BCSS was better than that of IDC ( P<0.05). Univariate and multivariate analysis showed that age, surgical approach and N stage were associated with poorer OS, while surgery approach, T stage, N stage and molecular typing were associated with worse BCSS ( P<0.05). Conclusions:Compared with IDC, EPC of breast has better BCSS and lower lymph node metastasis rate. There is a certain correlation between tumor stage and molecular type and prognosis of EPC.
ABSTRACT
10.3969/j.issn.1007-3969.2013.05.007