The origins of medullary carcinoma and papillary carcinoma of thyroid are embryologically different. We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. In this case, the occurrence of the two tumors may be a coincidence, does not have embryological or genetical significance.
Carcinoma, Medullary ; Carcinoma, Papillary* ; Thyroid Gland*

Hyalinizing trabecular adenoma of the thyroid gland is a distinctive benign epithelial lesion exhibiting a prominent trabecular arrangement and stromal hyalinization. We recently recognized a hyalinizing trabecular adenoma of the thyroid that displayed potentially misleading features of papillary and medullary carcinomas. However the immunohistochemical features, i.e. thyroglobulin-positive and calcitonin-negative as well as its trabecular arrangement and surrounding abundant hyaline materials confirmed our diagnosis.
Adenoma* ; Carcinoma, Medullary ; Diagnosis ; Hyalin* ; Thyroid Gland*

Carcinoma, Medullary ; pathology ; Duodenal Neoplasms ; pathology ; Humans

No abstract available.
Biopsy, Fine-Needle* ; Carcinoma, Medullary* ; Thyroid Gland*

Most medullary thyroid carcinomas show suspicious malignant features such as hypoechogenicity, a spiculated margin and/or intranodular calcifications, which are well known features of papillary carcinoma. We report here on a case of medullary carcinoma that was seen as a predominantly cystic thyroid mass on ultrasonography. This type of case is not common in the literature and we discuss the way to diagnose a medullary thyroid carcinoma.
Carcinoma, Medullary ; Carcinoma, Papillary ; Neck ; Thyroid Gland ; Thyroid Neoplasms

Medullary carcinoma(MC) of the breast is an uncommon histologic form of infiltrating ductal carcinoma and the cytologic features of MC are not well delineated.
Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Medullary*

PURPOSE: Reclassfication of the medullary carcinoma using a strict histologic criteria and analysis of the clinical and pathological characteristics of the medullary carcinoma. MATERIAL & METHODS: Thirty-seven cases of the breast carcinoma originally diagnosed as medullary carcinoma were reviewed. One to ten microscopic slides of each case were reexamined and reclassified using the strictly defined histologic criteria defined by Ridolfi et al. Tumors were excluded from the category of the typical medullary carcinoma (TMC) on the basis of presence of glandular features, focal marginal infiltrations, or sparse mononuclear infiltrations. Tumor with two or more atypical features, or extensive marginal infiltrations, no mononuclear cell infiltration and/or less than 75% syncytial growth were classified as infiltrating ductal carcinoma with medullary feature (IDC). A predominantly syncytial growth pattern (75% or more) was requisite for inclusion in both TMC and atypical medullary carcinomas (AMC). RESULTS: Twenty-two tumors (60%) fulfilled the criteria for TMC, and 12 tumors (32%) were AMC and three tumors (8%) were IDC. TMC occupied 3.1% of breast cancer. The mean age of patients with TMC was 45.4+/-11.2 years and the average size of the tumor in TMC was slightly larger than that of breast cancer in general, although not statistically significant. The frequency of lymph node metastasis in TMC was similar to breast cancer in general. Five year survival of patients with TMC was 95.5% which was significantly better than breast cancer in general. CONCLUSION: The TMC occupied 3.1% of breast cancer. The mean age of patient, tumor size and lymphnode metastasis were not different from that of breast cancer but 5 years survival of patient with TMC was significantly better than breast cancer in general.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Medullary* ; Humans ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. METHODS: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. RESULTS: With reviewing the pathologic slides, 69 (75.8%) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2%) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9%/16.2%) and AMC (15.0%/20.0%) as compared to the NOS (63.2%/57.2%), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4%) and AMC (45.5%) than in the NOS (28.3%, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8%, 77.8%) were in fact similar to the NOS carcinoma patients (68.3%, 74.7%). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8%, 86.0%) and NOS carcinoma (68.3%, 74.7%) patients (p=0.002, p=0.006). CONCLUSION: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Medullary ; Disease-Free Survival ; Humans ; Lymph Nodes ; Prognosis

BACKGROUND: Follicular neoplasm (FN) or Hurthle cell neoplasm (HN) is a less well understood pitfall when evaluating thyroid nodule with fine-needle aspiration (FNA). This study aimed to determine the rates of malignancy and the predictive factors for malignancy in thyroid nodules with a cytological diagnosis of FN or HN. METHODS: The patients who were cytologically diagnosed as having FN or HN after FNA between 1995 and 2004 at Asan Medical Center were included in this study. We collected the pathology data until 2009 and we analyzed the clinical characteristics associated with malignancy. RESULTS: A total 478 patients were cytologically diagnosed as having FN or HN during the study period and 327 (68%) among them underwent thyroid surgery. Thyroid malignancy was confirmed in 157 (48%) of 327 patients. Malignancy was confirmed in 124 patients with FN (124/253, 49%). They were 48 papillary, 65 follicular, 7 Hurthle cell and 3 medullary carcinomas and 1 anaplastic carcinoma. The malignancy in the cases of HN (33/71, 44.6%) was 9 papillary, 4 follicular and 20 Hurthle cell carcinomas. The risk of malignancy was not associated with male gender, a larger tumor size (> 4 cm) or the diagnosis of HN. However, an age below 20 years (RR 3.6, P = 0.03) and above 60 years (RR 2.3, P = 0.04) was associated with an increased risk of malignancy. CONCLUSION: About half of the patients with FN or HN on FNA cytology were diagnosed as having thyroid cancer after surgery. The malignancy rate for the cytologic diagnosis of HN was similar to that for FN. Thyroid surgery should be recommended for this situation, and especially for patients younger than 20 years or older than 60 years.
Biopsy, Fine-Needle ; Carcinoma ; Carcinoma, Medullary ; Humans ; Male ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

PURPOSE: The sodium-iodide symporter (NIS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NIS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression of NIS using two different methods (RT-PCR and immunoshistochemical staining) and compared the results. MATERIALS AND METHODS: We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 1 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. RESULTS: By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NIS. By immunohistochemical staining, 15 of 19 papaillary carcinomas express NIS, but 1 follicular cancer didn't express NIS. There was a significant correlation between the semiquantitative results of RT-PCR and immunohistochemical staining of NIS expression. (p< 0.01) CONCLUSION: Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Humans ; Hyperplasia ; Ion Transport* ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Nodule*