A New Indicator to Differentiate Thyroid Follicular Inclusions in Cervical Lymph Nodes from Patients with Thyroid Cancer

Otsubo C. Mussazhanova Z. Kurohama H. Shalgimbayeva G. Ueki N. Matsuoka Y. Madiyeva M. Sato S. Yamashita H. Nakashima M.
January 2023 MDPI

International Journal of Molecular Sciences
2023 #24 Issue 1

Nodal metastasis is crucial for determining the stage of well-differentiated thyroid cancer (WTC) in patients older than 55. Well-formed thyroid follicular inclusions (TFIs) are occasionally encountered in the cervical lymph nodes (LNs) of patients with papillary thyroid carcinoma (PTC), and it is difficult to determine whether they are true nodal metastases or ectopic thyroid tissues (ETT). This study aimed to elucidate the impact of the expression of the DNA damage response molecule TP53-binding protein 1 (53BP1) using immunofluorescence (IF) as a biomarker to differentiate TFIs in cervical LN by comparing the mutation analyses of primary thyroid cancers. The data demonstrated the necessity for the differential diagnosis of true metastases from ETT among TFIs in cervical LNs. PTC-like nuclear features using hematoxylin–eosin staining combined with immunohistochemistry for conventional biomarkers of PTC, including BRAF^V600E protein, were most helpful in identifying metastatic follicular-patterned carcinomas. In conclusion, IF analysis of 53BP1 expression could be an excellent ancillary technique to distinguish metastatic carcinoma or ETT from TFIs in LNs, particularly in cases other than BRAF^V600E-mutated PTC.

53BP1 , ectopic thyroid tissue , immunofluorescence , nodal metastasis , thyroid follicular inclusion

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Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
Department of Fundamental Medicine, Al-Farabi Kazakh National University, Almaty, 050040, Kazakhstan
Department of Diagnostic Pathology, Nagasaki University Hospital, Nagasaki, 852-8523, Japan
Department of Pathophysiology, Semey Medical University, Semey, 071400, Kazakhstan
Nagasaki Regional Supportive Center for Diagnostic Pathology, Nagasaki University Hospital, Nagasaki, 852-8523, Japan
Department of Radiology, Semey Medical University, Semey, 071400, Kazakhstan
Yamashita Thyroid Hospital, Fukuoka, 812-0034, Japan

Department of Tumor and Diagnostic Pathology
Department of Fundamental Medicine
Department of Diagnostic Pathology
Department of Pathophysiology
Nagasaki Regional Supportive Center for Diagnostic Pathology
Department of Radiology
Yamashita Thyroid Hospital

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