Immunohistochemical Expression of Cytokeratin-19 in Thyroid Nodules and Its Correlation With Histopathology

Authors

  • Suriyaprabha Palanisamy Assistant professor Department of pathology Theni medical college
  • Dhanalakshmi Arumugam
  • Sudha Boj

Keywords:

Papillary Carcinoma, Follicular Adenoma, Follicular Carcinoma, Cytokeratin 19

Abstract

Background: Thyroid neoplasms constitute the most commonly occurring endocrine tumors worldwide. They commonly occur between 30-60 years of age and affect both sexes.  Papillary carcinoma is the most common malignant tumor constituting 80-85% of all the thyroid carcinomas followed by follicular carcinoma comprising 10-15%. Diagnosis becomes challenging when typical features are not seen or when overlapping features are present. In such cases immunohistochemistry can be done to make correct diagnosis.

 

 Methods: In this study we observed the immunohistochemical expression of Cytokeratin19 in 30 thyroidectomy specimens which included classic papillary carcinoma (11 cases), follicular variant of papillary carcinoma (2 cases), follicular adenoma (15 cases) and follicular carcinoma (4 cases). The study period was one year. The scoring was given from 0- 3+ based on the percentage of cells showing membrane and cytoplasmic positivity and intensity of staining. 

Result: The staining results of Cytokeratin19 showed diffuse and strong 3+ positivity in 8/11 cases  of papillary carcinoma and its follicular variant, 2 cases showed 2+ positivity and one case with 1+ positivity. Majority of the cases of follicular adenoma (13/15 cases) and follicular carcinoma (3/4 cases) showed negative staining. Only 2 cases of follicular adenoma and 1 case of follicular carcinoma showed focal weak positivity.

Conclusion: Cytokeratin19 was found to be a sensitive and specific marker in diagnosing papillary carcinoma and its follicular variant. But it does not differentiate follicular neoplasms. Hence a good panel of markers is essential in arriving at exact diagnosis of thyroid neoplasms in challenging cases.

 

DOI: 10.21276/APALM.2017.1053

 

Author Biography

Suriyaprabha Palanisamy, Assistant professor Department of pathology Theni medical college

Assistant professor

Department of pathology

Theni medical college.

References

1. Oestreicher-Kedem Y, Halpern M, Roizman P, Hardy B, Sulkes J, Feinmesser R, Stern Y. Diagnostic value of galectin3 as a marker for malignancy in follicular patterned thyroid lesion. Head Neck. 2004; 26(11):960-6.
2. Gilliland F D, Hunt W C, Morris D M et al. 1997 Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973-1991. Cancer 79: 564-573.
3. Barroeta JE, Baloch ZW, Lal P, Pasha TL, Zhang PJ, LiVolsi VA. Diagnostic value of differential expression of CK19 Galectin-3, HME-1, ERK, RET and p16 in benign and malignant follicular derived lesions of the thyroid- an immunohistochemical tissue microarray analysis. Endocr Pathol. 2006; 17(3):225-34.
4. LiVolsi VA. Current concepts in follicular tumors of thyroid. Monogr Pathol. 1993:118-137.
5. Fonseca E, Soares P, Cardoso-Oliveira M, Sobrinho-Simões M. Diagnostic criteria in well-differentiated thyroid carcinomas. Endocr Pathol, 2006; 17:109-117.
6. Chan JK. Strict criteria should be applied in the diagnosis of encapsulated follicular variant of papillary thyroid carcinoma. Am J Clin Pathol.2002; 117: 16-18.
7. Alshenawy HA. Utility of immunohistochemical markers in differential diagnosis of follicular cell-derived thyroid lesions. Journal of Microscopy and Ultrastructure. 2014; 2(3): 127-136.
8. Ozolins A, Narbuts Z, Strumfa I, Volanska G, Stepanovs K, Gardovskis J. Immunohistochemical expression of HBME-1, E-cadherin, and CD56 in the differential diagnosis of thyroid nodules. Medicina (Kaunas). 2012; 48(10): 507-14.
9. Saleh HA., et al. Utility of immunohistochemical markers in differentiating benign from malignant follicular-derived thyroid nodules. Diagnostic Pathology.2010; 5: 9.
10. Fadda G, Rossi ED, Raffaelli M, Pontecorvi A, Sioletic S, Morassi F et al. Follicular thyroid neoplasms can be classified as low and high risk according to HBME-1 and Galectin-3 expression on liquid based fine needle cytology. Eur J Endocrinol. 2011; 165 (3):447-453.
11. Lam K Y, Lui MC, Lo CY: Cytokeratin expression profiles in thyroid carcinomas. Eur J Surg Oncol. 2001; 27(7): 631-5.
12. Demellawy DE, Nasr A, Alowami S. Application of CD56, p63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid. Diagn Pathol.2008; 3: 5.

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Published

23-02-2017

How to Cite

1.
Palanisamy S, Arumugam D, Boj S. Immunohistochemical Expression of Cytokeratin-19 in Thyroid Nodules and Its Correlation With Histopathology. Ann of Pathol and Lab Med [Internet]. 2017 Feb. 23 [cited 2024 Dec. 27];4(1):A100-105. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1053

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Original Article