Defining angioinvasion and lymphatic invasion in papillary thyroid carcinoma: Morphological criteria, utility of D2-40/CD31/ERG immunohistochemistry and correlation with clinicopathological characteristics Journal Article
| Authors: | Xu, B.; Roy, D.; Serrette, R.; Ghossein, R. |
| Article Title: | Defining angioinvasion and lymphatic invasion in papillary thyroid carcinoma: Morphological criteria, utility of D2-40/CD31/ERG immunohistochemistry and correlation with clinicopathological characteristics |
| Abstract: | Aims: While CAP and ICCR protocols mandate the separation of angioinvasion (AI) and lymphatic invasion (LI) in thyroid carcinoma, distinction between them can be difficult. Because the presence of AI is used to stratify patients with papillary thyroid carcinoma (PTC), there is a need to accurately diagnose AI and LI. Methods and results: AI and LI were evaluated in 162 cases of PTC (n = 155) and high-grade differentiated thyroid carcinoma, papillary phenotype (HGDTCp, n = seven) using haematoxylin and eosin (H&E), D2-40 and CD31/ERG. In encapsulated carcinomas, vascular invasion (VI) was only of AI nature. Infiltrative carcinomas showed LI (46 of 131, 35%) and AI (19 of 131, 16%). The frequency of nodal metastasis (NM) and large volume of NM was 93 and 85%, respectively, in tumours with LI, and 39 and 26%, respectively, in those without LI. Luminal red blood cells and smooth muscle in the wall of large-calibre vessels were not reliable criteria to exclude LI and were seen in 23 and 6% of LI, respectively. LI was an independent predictor for NM, whereas AI is an independent predictor for distant metastasis at presentation in PTC/HGDTCp. Conclusion: VI in encapsulated carcinomas, including follicular variant PTC, is only of AI nature, confirming the position of this variant as a close entity to follicular carcinoma rather than classic PTC, whereas infiltrative PTC/HGDTCp may have LI or, less frequently, AI. As no morphological features reliably distinguish LI from AI, D2-40 and CD31/ERG immunostains should be considered for separating AI from LI when dealing with vascular invasion in an infiltrative PTC. © 2024 John Wiley & Sons Ltd. |
| Keywords: | immunohistochemistry; adolescent; adult; child; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; young adult; major clinical study; cancer staging; lymph node metastasis; cancer diagnosis; lymphatic metastasis; phenotype; metabolism; tumor volume; carcinoma, papillary; pathology; neovascularization, pathologic; tumor marker; distant metastasis; monoclonal antibody; diagnosis; world health organization; sex difference; neoplasm invasiveness; thyroid neoplasms; papillary carcinoma; neovascularization (pathology); thyroid papillary carcinoma; thyroid tumor; monoclonal antibody d2-40; smooth muscle; erythrocyte count; differentiated thyroid cancer; lymphatic invasion; tumor invasion; oncological parameters; antibodies, monoclonal, murine-derived; papillary thyroid carcinoma; tumor immunogenicity; very elderly; humans; human; male; female; article; biomarkers, tumor; platelet endothelial cell adhesion molecule 1; thyroid cancer, papillary; high-grade differentiated thyroid carcinoma; angioinvasion; platelet endothelial cell adhesion molecule-1; pecam1 protein, human |
| Journal Title: | Histopathology |
| Volume: | 85 |
| Issue: | 6 |
| ISSN: | 0309-0167 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2024-12-01 |
| Start Page: | 950 |
| End Page: | 958 |
| Language: | English |
| DOI: | 10.1111/his.15285 |
| PUBMED: | 39030854 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is Ronald Ghossein -- Source: Scopus |
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