Follicular tumors of the thyroid gland: Diagnosis, clinical aspects and nuclear DNA analysis (original) (raw)

1992, World Journal of Surgery

Weden. Nine of the patients had tumors which were diagnosed as follicular carcinoma, 4 of whom had recurrences in the neck region. In 6 ~f the patientS the carcinomas were diagnosed as widely invasive and in 3 Patients as minimally invasive. Of the 160 patients with follicular adeno-~as, 21 adenomas were of oxyphil type ("Hiirthle" adenomas), 17 adenomas were diagnosed as "atypical", and 6 adenomas were classified as being both "atypical" and having oxyphil cell differentiation. The ~Uelear DNA content was measured with image cytometry and/or flow Yt°metry. Six of the 9 carcinomas were euploid and 3 were aneuploid. In sh~ adenoma group, 32 (20%) were aneuploid. Thus 38% of all adenomas ~°eWed atypical cellular features, oxyphii cell differentiation, and/or sLeUPloid nuclear DNA pattern. None of the patients with adenomas have ;~Own any sign of recurrence. In the present prospective study, the uelear DNA content could not discriminate between a benign and a ~ lignant follicular tumor, and was of limited value in predicting °ghosts in the patients with follicular carcinoma. Still, the best way to ~S~blish a diagnosis and to predict prognosis is to surgically remove the "mCular tumor for a proper histopathological examination. Carcinoma of the thyroid gland is a fairly rare disease and constitutes about 1% of all carcinomas. From 1984 to 1988, an ~ Verage of 38,549 malignant tumors was reported yearly to the t, dish Cancer Registry of The National Swedish Board of 'lealth and Welfare. The annual average number of thyroid Carcinomas was 331. Follicular carcinomas, reported to comprise about 20% of all thyroid carcinomas [!, 2], are generally classified according to !heir degree ofinvasiveness, i.e., minimally invasive and widely InVasive [3]. Especially the former subtype is reported to have ap fairly good prognosis, but the clinical behavior is not always redlctable from the histopathological pattern. Various clinical