Cribriform Morular Thyroid Carcinoma: A Rare Case and Associated Uncommon Features

Int J Surg Pathol. 2024 Aug;32(5):1009-1016. doi: 10.1177/10668969231206572. Epub 2023 Oct 25.

Abstract

Cribriform morular thyroid carcinoma has been added under tumors of uncertain histogenesis. Its peculiar clinical, histomorphological pattern, and immunohistochemical profile have been proved different from papillary thyroid carcinoma. A 59-year-old female patient had a lesion in the left lobe of the thyroid. Fine needle aspiration cytology was reported as medullary thyroid carcinoma. The total thyroidectomy specimen showed a predominantly solid tumor of size 9.5 cm in the left lobe. Microscopy showed a mixed growth pattern with the dominant cribriform and solid morular area. Nuclear features of papillary carcinoma were not seen. Squamoid morules had nuclear clearing. Marked stromal hyalinization and calcification were noted. Extrathyroidal extension, lymphovascular invasion, and lymph node metastasis were not identified. Immunohistochemically the tumor cells were diffuse and strong nuclear positive for β-catenin, TTF1, PAX8, estrogen receptor, focal, and weak positivity for CD5. Synaptophysin, calcitonin, thyroglobulin, and CDX2 were negative. We report this rare cribriform morular thyroid carcinoma case with its associated uncommon histological and immunohistochemical features.

Keywords: CD5; ER; cribriform-morular; squamoid; thyroid; β-catenin.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor* / analysis
  • Biomarkers, Tumor* / metabolism
  • Biopsy, Fine-Needle
  • Carcinoma, Neuroendocrine / diagnosis
  • Carcinoma, Neuroendocrine / pathology
  • Carcinoma, Neuroendocrine / surgery
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Thyroid Gland / pathology
  • Thyroid Gland / surgery
  • Thyroid Neoplasms* / diagnosis
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy

Substances

  • Biomarkers, Tumor

Supplementary concepts

  • Thyroid cancer, medullary