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Primary mucinous carcinoma of thyroid gland with prominent signet-ring-cell differentiation: a case report and review of the literature

Authors Wang J, Guli QR, Ming XC, Zhou HT, Cui YJ, Jiang YF, Zhang D, Liu Y

Received 5 December 2017

Accepted for publication 20 February 2018

Published 16 March 2018 Volume 2018:11 Pages 1521—1528


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 3

Editor who approved publication: Dr Carlos E Vigil

Jian Wang,1,2 Qie-Re Guli,3 Xiao-Cui Ming,3 Hai-Tao Zhou,3 Yong-Jie Cui,3 Yue-Feng Jiang,1,2 Di Zhang,1,2 Yang Liu1,2

Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China; 2Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; 3Department of Pathology, The People’s Hospital of Tacheng Region, Tacheng, China

Purpose: This study reports a case of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation, and reviews the literature to evaluate its real incidence and the prognosis of these patients.
Patients and methods: A 74-year-old Chinese woman, presenting with a mass in the right lobe of thyroid gland, came to the hospital. Computed tomography revealed a mass in the right lobe of the thyroid gland, accompanied with right neck lymphadenectasis and airway deviation caused by tumor compression. Thyroid imaging suggested a thyroid malignant tumor and suspicious lymph node metastasis. Histologically, the tumor was characterized by the tumor cells arranged in small nests or trabeculae with an abundant extracellular mucoid matrix. The tumor cells formed diffuse invasion among thyroid follicles. In the peripheral regions, prominent signet-ring-cells formed a sheet-like structure and extended into the extrathyroidal fat tissue. The tumor cells were diffusely positive for thyroid transcription factor-1 (TTF-1) and PAX8, while they were focally positive for pan-cytokeratin (AE1/AE3) and weakly expressed thyroglobulin.
Results: Based on the histological features and immunohistochemical profile, a diagnosis of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation was rendered.
Conclusion: Using a panel of immunohistochemical markers may be helpful for differential diagnosis and for determining whether the tumor is primary or not.

Keywords: mucinous carcinoma, primary thyroid cancer, signet-ring-cell differentiation, immunohistochemistry

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