Genetic heterogeneity of benign thyroid lesions. Static and flow cytometry, karyotyping and in situ hybridization analysis.

The present series includes 75 thyroid lesions (38 goiters, 30 adenomas, 3 follicullo-papillary encapsulated carcinomas and 4 normal thyroid) that were studied by static and flow cytometry. Four cases were also analyzed by in situ hybridization (centromeric probes for chromosomes 1 and 17) and 10 cases by G-banding cytogenetics. Results demonstrate a polymorphism and genetic instability in the thyroid tissue that may be related to the spontaneous polyploidization of their cells. The most consistent finding in cytometry was the presence of two clones associated with clinical or histological hyperactivity (46% versus 23% in non-functioning cases; chi2 distribution with a p < 0.05). Chromosomal anomalies were detected in two out of 10 cases: 46, XX, t(5,19) in 87% of cells of a diffuse hyperplastic goiter and 49, XX, +7, +17, +22 in 19% of cells of thyroiditis case. Finally, the in situ hybridization technique showed hidden trisomies of clonal origin in all of the cases studied. Evaluation of clonal trisomies by the in situ hybridization technique using the confidence interval of a binomial distribution is discussed.

Chromatin texture from hematoxylin stained thyroid lesions.

Quantitative aspects of cytology and histology should be considered in diagnostic standardisation processes. The present paper summarises the cytological differences detected in 75 thyroid lesions using a computerized textural analysis. Cells stained with progressive hematoxylin and taken from paraffin blocks were overlaid with the extracted texture. This technique was based on the lineal detection of a grey level gradient of the common logarithm of the integrated optical density (IOD) of each nucleus. Diffuse and nodular goiters (36 cases) were demonstrated to be composed of small cells containing high density texture that, on microscopical visual inspection, gave a "salt and pepper" appearance. The adenomatous goiters (2 cases) and adenomas (26 cases) were composed of low texture cells with a visual "blurry or smudgy" chromatin, while the atypical adenomas with capsular invasion (4 cases) were characterised by a "woodworm" nuclear appearance that produced the highest texture of the series. Finally, encapsulated folliculo-papillary carcinomas (3 cases) were composed of large clear nuclei with high IOD, low texture, and scattered lines that resulted in an "empty grape skin" aspect. Our findings seam to confirm the suitability of computerized textural techniques that aid in recognizing cell microscopic features objectively. The one used in the present work, based on a mathematical function of the DNA content of each individual nucleus (IOD), fulfills all microscopy detection criteria.

Translocation (5;19)(q13;q13) in a multinodular thyroid goiter.

We describe the cytogenetics of a multinodular thyroid goiter where 90% of the analyzed cells showed a diploid karyotype with a balanced translocation between chromosomes 5 and 19: 46,XX,t(5;19)(q13;q13). This translocation has been previously described in cases of thyroid adenoma. Our case is the first report of this anomaly in nodular hyperplasia. We discuss its putative role in the neoplastic transformation of thyroid lesions.