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KMID : 0356620080230050327
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Journal of Korean Society of Endocrinology
2008 Volume.23 No. 5 p.327 ~ p.331
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A Case of Hyalinizing Trabecular Tumor of the Thyroid Gland Misdiagnosed as Medullary Carcinoma at Cytologic Examination
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Han Jae-Joon
Lee Yun-Jung
Choi Moon-Chan
Kwon Mi-Kwang
Chon Suk
Lee Ju-Hie
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Abstract
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A hyalinizing trabecular tumor (HTT) is a rare benign thyroid tumor that can present as a solitary thyroid nodule, a prominent nodule in a multinodular goiter, or as an incidental finding within a thyroidectomy specimen. The clinical importance of this entity is that it is frequently misdiagnosed as papillary carcinoma or medullary carcinoma on fine-needle aspiration cytology or histopathologic examination. The cytology of HTT is characterized by hypercellularity, nuclear grooves, nuclear pseudoinclusions, and powdery chromatin of the tumor cells, which is frequently seen in papillary carcinomas. The histologic findings of the tumor show polygonal and spindle cells arranged in a trabecular growth pattern with the presence of a variable hyalinized stroma. Calcitonin and other neuroendocrine markers can be used to differentiate HTT from medullary carcinoma. MIB-1, galectin-3, or other cytokeratin markers help to exclude papillary carcinoma. We report a patient with a thyroid tumor misdiagnosed as a medullary carcinoma on fine-needle aspiration and finally diagnosed as HTT after total thyroidectomy and immunohistochemical examination.
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KEYWORD
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fine needle aspiration, hyalinizing trabecular tumor, thyroid nodules
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