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Papillary Thyroid Carcinoma with Predominant Spindle Cell Component: Report of Two Rare Cases and Discussion on the Differential Diagnosis with Other Spindled Thyroid Neoplasm
Authors:Stefania Corrado  Salvatore Maria Corsello  Antonio Maiorana  Esther Diana Rossi  Alfredo Pontecorvi  Guido Fadda  Giampaolo Papi
Institution:1. Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
2. Institute of Endocrinology, Catholic University of Rome, Rome, Italy
3. Institute of Pathology, Catholic University of Rome, Rome, Italy
4. Dipartimento di Medicina Interna, Reparto di Endocrinologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 00168, Rome, Italy
Abstract:Spindle cell transformation or metaplasia has been so far demonstrated in the context of both benign and malignant conditions. Spindle cell lesions of the thyroid gland of either primary or secondary origin to metastatic disease represent rare entities. We describe two patients with papillary thyroid carcinoma (PTC) showing spindle cell metaplasia, submitted to thyroidectomy due to euthyroid bilateral nodular thyroid disease. Cytological examination of fine-needle aspiration biopsy performed in the dominant nodules was consistent with follicular neoplasm in one case and with a hyperplastic/adenomatous nodule in the other patient. Histological examination disclosed unencapsulated follicular variant of PTC with spindle cell metaplasia in either cases. Both patients are doing well without clinical or laboratory evidence of PTC recurrence at 3- and 1-year follow-up, respectively. We present the clinical, pathological, and immunohistochemical aspects of these unusual cases and thoroughly discuss the differential diagnosis with other spindle cell lesions of the thyroid gland.
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