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Presented by Dr. Ashley Cimino-Mathews and prepared by Dr. Harsimar Kaur.
A 45 year-old female underwent a hemithyroidectomy for a thyroid nodule.
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1. Question
A 45 year-old female underwent a hemithyroidectomy for a thyroid nodule.
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Correct Answer:
B. Hyalinizing trabecular adenomaDiscussion:
Hyalinizing trabecular adenoma (sometimes referred to as hyalinizing trabecular “tumor” or “neoplasm”) is a benign thyroid neoplasm with the nuclear features of papillary thyroid carcinoma; that is, the nuclei display elongation, overlap, clearing, grooves, and pseudoinclusions. However, the cells are arranged in a nested or trabecular architecture, resembling cords or ribbons of cells, and are invested by a collagenous (hyalinized) matrix. The tumor lacks papillary architecture or follicular-pattern growth. Hyalinizing trabecular adenomas have been recently characterized to have rearrangements between PAX8 and GLIS1 or GLIS3, which is unique and distinct from the genetic changes of papillary thyroid carcinomas. Hyalinizing trabecular adenomas are important to recognize as distinct from papillary thyroid carcinomas, because hyalinizing trabecular adenomas are uniformly benign and do not require any additional therapy or monitoringReferences:
1. Nikiforova MN, et al. GLIS Rearrangement is a Genomic Hallmark of Hyalinizing Trabecular Tumor of the Thyroid Gland. Thyroid. 2019 Feb;29(2):161-173.
2. Marchiò C, et al. PAX8-GLIS3 gene fusion is a pathognomonic genetic alteration of hyalinizing trabecular tumors of the thyroid. Mod Pathol. 2019 Jul 4. [Epub ahead of print]Incorrect
Correct Answer:
B. Hyalinizing trabecular adenomaDiscussion:
Hyalinizing trabecular adenoma (sometimes referred to as hyalinizing trabecular “tumor” or “neoplasm”) is a benign thyroid neoplasm with the nuclear features of papillary thyroid carcinoma; that is, the nuclei display elongation, overlap, clearing, grooves, and pseudoinclusions. However, the cells are arranged in a nested or trabecular architecture, resembling cords or ribbons of cells, and are invested by a collagenous (hyalinized) matrix. The tumor lacks papillary architecture or follicular-pattern growth. Hyalinizing trabecular adenomas have been recently characterized to have rearrangements between PAX8 and GLIS1 or GLIS3, which is unique and distinct from the genetic changes of papillary thyroid carcinomas. Hyalinizing trabecular adenomas are important to recognize as distinct from papillary thyroid carcinomas, because hyalinizing trabecular adenomas are uniformly benign and do not require any additional therapy or monitoringReferences:
1. Nikiforova MN, et al. GLIS Rearrangement is a Genomic Hallmark of Hyalinizing Trabecular Tumor of the Thyroid Gland. Thyroid. 2019 Feb;29(2):161-173.
2. Marchiò C, et al. PAX8-GLIS3 gene fusion is a pathognomonic genetic alteration of hyalinizing trabecular tumors of the thyroid. Mod Pathol. 2019 Jul 4. [Epub ahead of print]
