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Journal Information
Vol. 56. Issue 2.
Pages 115 (February 2020)
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Vol. 56. Issue 2.
Pages 115 (February 2020)
Clinical Image
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Pulmonary Metastasis of Cribriform-Morular Variant of Thyroid Carcinoma
Metástasis pulmonar de la variante cribiforme-morular de carcinoma tiroideo
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Juan Laforgaa,
Corresponding author
jblaforga@gmail.com

Corresponding author.
, Teresa Pedrob
a Department of Pathology, Hospital de Dénia, Spain
b Department of Endocrinology, Hospital de Dénia, Spain
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Cribriform-morular variant of thyroid carcinoma (CMV-TC) is an uncommon variant of papillary thyroid carcinoma.1 The immunohistochemical phenotype is thyroid transcription factor (TTF-1+) with focal staining for thyroglobulin, cytokeratin 7 (CK7) and CK19. The hallmark feature, however, is strong staining for β-catenin. CMV-TC metastasizes to the regional lymph nodes in 10% of patients and to distant sites in 6%.2 We report a case of sporadic CMV-TC in a 45-year-old woman with regional lymph node metastases and, 7 years after diagnosis, lung metastases. Thoracic CT showed multiple bilateral nodules measuring up to 2cm in diameter. In 2018, a chest CT scan revealed a significant increase in nodule size and multiple lesions in the left lower lobe (Fig. 1A). The lesions were positive by PET and a lung core biopsy was performed. The immunohistochemical study showed strong, diffuse positivity for β-catenin, TTF-1, ER and PR (Fig. 1B–D), all characteristic findings in CMV-TC.

Fig. 1.

(A) Thorax computed tomography scan showing bilateral multiple nodules. (B) Tumor cells showing strong, diffuse staining for β-catenin. β-Catenin 400×. (C) Diffuse staining of tumor cell nuclei with thyroid transcription factor (TTF-1). TTF-1, 200×. (D) Tumor cells showing diffuse, strong staining with progesterone receptors. Progesterone receptor, 200×.

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References
[1]
J. Rosai, J. Albores Saavedra, S. Asioli, et al.
Papillary thyroid carcinoma.
World Health Organization Classification of Tumors. Pathology and genetics of tumours of endocrine organs, 4th ed., pp. 81-91
[2]
J.M. Cameselle-Teijeiro, D. Peteiro-González, J. Caneiro-Gómez, M. Sánchez-Ares, I. Abdulkader, C. Eloy, et al.
Cribriform-morular variant of thyroid carcinoma: a neoplasm with distinctive phenotype associated with the activation of the WNT/β-catenin pathway.
Mod Pathol, 31 (2018), pp. 1168-1179
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