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Review ArticleTeaching Case Studies

Evolution of Papillary Thyroid Carcinoma into Tall Cell Variant and TENIS Syndrome

Avik Chakraborty, S.V. Kane, Yogita Pawer and Sandip Basu
Journal of Nuclear Medicine Technology December 2016, 44 (4) 255-258; DOI: https://doi.org/10.2967/jnmt.116.181396
Avik Chakraborty
1Radiation Medicine Centre, BARC, Mumbai, India; and
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S.V. Kane
2Department of Pathology, Tata Memorial Hospital, Mumbai, India
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Yogita Pawer
1Radiation Medicine Centre, BARC, Mumbai, India; and
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Sandip Basu
1Radiation Medicine Centre, BARC, Mumbai, India; and
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    FIGURE 1.

    131I scan. High count neck and chest view of 131I whole-body scan during last recurrence obtained 72 h after oral administration of 148 MBq of 131I demonstrates no abnormal focus in neck and chest, implying palpable neck nodes are non–iodine-concentrating (a feature of dedifferentiation in thyroid carcinoma).

  • FIGURE 2.
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    FIGURE 2.

    18F-FDG PET scan. Whole-body 18F-FDG PET (coronal slices) images during time of last recurrence obtained 60 min after injection of 370 MBq of 18F-FDG demonstrates multiple 18F-FDG–avid neck nodes (SUVmax, 10.3). Last slide demonstrates 18F-FDG–avid metastatic right pulmonary lesions (SUVmax, 38.1).

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    FIGURE 3.

    Hematoxylin and eosin sections (200×); TCV of PTC. (A) Note compactly arranged fingerlike projections with dense eosinophilic cytoplasm, overlapping nuclei, and pseudoinclusion (arrows). (B) Hematoxylin and eosin section (400×) shows papillary projections covered by tall cells (arrows).

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    FIGURE 4.

    BRAF mutation. (A) Sequence chromatograph of tumor showing heterozygous BRAF T1799A mutation. (B) BRAFI582M point mutation in same tissue specimen. (C) Real-time polymerase chain reaction: graph shows relative messenger RNA expression. Two-fold increase on MUC1 level is observed. (D) Semiquantitative real-time polymerase chain reaction: muc1 gene (upper) with respective β actin genes (lower).

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    FIGURE 5.

    Immunohistochemical detection of different tumor markers (200×): Cyclin D1 (A), galectin-3 (B), HBME1 (C), and CK19 (D).

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Journal of Nuclear Medicine Technology: 44 (4)
Journal of Nuclear Medicine Technology
Vol. 44, Issue 4
December 1, 2016
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Evolution of Papillary Thyroid Carcinoma into Tall Cell Variant and TENIS Syndrome
Avik Chakraborty, S.V. Kane, Yogita Pawer, Sandip Basu
Journal of Nuclear Medicine Technology Dec 2016, 44 (4) 255-258; DOI: 10.2967/jnmt.116.181396

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Evolution of Papillary Thyroid Carcinoma into Tall Cell Variant and TENIS Syndrome
Avik Chakraborty, S.V. Kane, Yogita Pawer, Sandip Basu
Journal of Nuclear Medicine Technology Dec 2016, 44 (4) 255-258; DOI: 10.2967/jnmt.116.181396
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Keywords

  • BRAF mutation
  • tall cell variant of PTC
  • lymph node metastasis
  • multiple recurrences
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