Hélio Bisi

Differential reactivity for galectin-3 in Hürthle cell adenomas and carcinomas

Hürthle cell carcinomas behave as the most aggressive variant of differentiated thyroid carcinoma of follicular origin, with frequent recurrences and higher morbidity. Its differential diagnosis with Hürthle cell adenoma remains a problem for the clinician and for the pathologist. The vertebrate lectins, galectin-1 and galectin-3 have been implicated in the regulation of cellular growth, differentiation, and malignant transformation in thyroid neoplasms. Galectin-3, a β-galactoside binding protein, has been recently found to be highly expressed in papillary and follicular carcinomas. The current study was undertaken to investigate immunohistochemical reactivity for galectin-3 of thyroid specimen tissues with Hürthle cell adenomas (n=14) and carcinomas (n=17), follicular (n=14) and papillary (n=11) carcinomas, colloid goiter (n=30), Hashimoto’s thyroiditis (n=11), follicular adenoma (n=9), and normal thyroid tissues (n=18). Follicular (78.5%) and papillary (82.0%) carcinomas were frequently reactive for galectin-3, more often when some Hürthle cells were present. There was no galectin-3 immunostaining in any of the specimens from Hashimoto’s thyroiditis, colloid goiters or normal thyroid samples, whereas only one case of follicular adenoma was found positive (11.1%). By contrast, galectin-3 immunostaining in Hürthle cell carcinomas was significantly higher (59%) than in Hürthle cell adenomas (7.1%, p<0.05). These results suggest that galectin-3 may potentially serve as a marker in difficult differential diagnosis cases involving Hürthle cell adenomas and Hürthle cell carcinomas.

Familial thyroid peroxidase defect.

A congenitally goitrous, mentally retarded, hypothyroid child, whose parents were first cousins, was studied for the cause of a strongly positive (86–5%) perchlorate discharge test. The mother had a recidivant goitre after being thyroidectomized in 1971. Her perchlorate discharge test was negative, but she displayed an exaggerated TSH response to TRH administration. The father also showed a negative perchlorate discharge, but he had a large cold nodule in the left thyroid lobe. The father also presented with a retinitis pigmentosa, detected additionally in two of his brothers and three nephews.

Identification of the primary site of metastatic adenocarcinoma in serous effusions: Value of an immunocytochemical panel added to the clinical arsenal

OBJECTIVEnTo use an immunocytochemical panel as ancillary method to identify the origin of adenocarcinomas in serous effusions.nnnSTUDY DESIGNnSerous effusion samples examined cytologically in the Department of Surgical Pathology, A. C. Camargo Hospital, between 1966 and 1990, were investigated. Of 4,297 cases, 2,317 were associated with adenocarcinoma, and 1,099 were positive for adenocarcinoma by cytologic examination. We selected a total of 248 cases of different origins to subject to immunoreactions. A panel composed of CA-125, CA-19.9, HBME-1, lactoferrin and BRST 2 was tested for the efficiency of these antibodies under two conditions: the panel alone and associated with clinical data, such as anatomic localization of the effusion (pleural or ascitic) and patient sex and age.nnnRESULTSnBRST 2 and lactoferrin were both positive in 29.9% of cases of adenocarcinoma of breast origin; CA-125 and HBME-1 were 28.6% and 25.0% positive in cases of adenocarcinoma of the ovaries, respectively. These immunoreactivities were highly specific when compared to the others. The statistical significance of the results was improved by information on the anatomic location of the effusions and patient sex.nnnCONCLUSIONnOur data strongly indicate that BRST 2 and lactoferrin are important components of an immunocytochemical panel used to identify carcinomas of breast origin. Similarly, CA-125 and HBME-1 may be useful in suggesting the ovaries as possible primary sites.

Prevalence of thyroiditis and immunohistochemistry study searching for a morphologic consensus in morphology of autoimmune thyroiditis in a 4613 autopsies series.

We sought to verify the prevalence of lymphocytic thyroiditis (LT) and Hashimoto’s thyroiditis (HT) in autopsy materials. Cases examined between 2003 and 2007 at the Department of Pathology of Faculty of Medicine of São Paulo University were studied. Immunohistochemical analyses were conducted in selected cases to characterize the type of infiltrating mononuclear cells; in addition, we evaluated the frequency of apoptosis by TUNEL assay technique and caspase-3 immunostaining. Significant increase in overall thyroiditis frequency was observed in the present series when compared with the previous report (2.2978% vs. 0.0392%). Thyroiditis was more prevalent among older people. Selected cases of LT and HT (40 cases each) had their infiltrating lymphocytes characterized by immunohistochemical analyses. Both LT and HT showed similar immunostaining patterns for CD4, CD8, CD68, thus supporting a common pathophysiology mechanism and indicating that LT and HT should be considered different presentations of a same condition, that is, autoimmune thyroiditis. Moreover, apoptosis markers strongly evidenced that apoptosis was present in all studied cases. Our results demonstrated an impressive increase in the prevalence of thyroiditis during recent years and our data support that the terminology of autoimmune thyroiditis should be used to designate both LT and HT. This classification would facilitate comparison of prevalence data from different series and studies.