CD56 expression in benign and malignant thyroid lesions

Santhia Muthusamy, Shamsul Azhar Shah, Shahrun Niza Abdullah Suhaimi, Norina Kassim, Mazne Mahasin, Muhammad Fakhri Mohd Saleh, Nurismah Md Isa

Research output: Contribution to journalArticle

Abstract

Introduction: Thyroid cancer is the most common endocrine malignancy with more than 95% originating from follicular epithelial cells. Diagnostic dilemma may arise in occasional cases such as when an encapsulated nodule with a follicular growth pattern exhibits clear nuclei with grooves making it difficult to distinguish a follicular adenoma from encapsulated follicular variant papillary thyroid carcinoma. This study aimed to evaluate the diagnostic utility of an immunohistochemical marker, CD56, to distinguish between benign and malignant thyroid lesions. Materials and Methods: We retrospectively studied CD56 expression in 54 benign and 54 malignant thyroid lesions using archival formalin fixed paraffin-embedded tissue blocks for the study period from January 2010 to December 2015, diagnosed in a tertiary hospital. Results: CD56 was expressed in 52/54 (96.3%) of benign specimens and only 24/54 (44.4%) of malignant ones. The malignant specimens comprised 31 (57.4%) papillary thyroid carcinomas (PTC), 11 (20.3%) follicular carcinomas (FC), seven (13%) medullary thyroid carcinomas (MC), one (1.9%) poorly differentiated carcinoma (PC) and four (7.4%) anaplastic carcinomas (AC). CD56 was not expressed in 28/31 (90.3%) of the PTCs, 1/11 (9.1%) FCs, 1/4 (25%) of ACs while all MCs and the PD were positive. The benign group comprised nodular hyperplasias (29/54), lymphocytic thyroiditis (10/54), follicular adenomas (FA) (14/54) and one hyalinising trabecular tumour. CD56 was expressed in all the benign cases except one FA and one nodular hyperplasia. Thirteen of the 14 FAs were CD56 positive. The difference in expression between benign and malignant tumours was statistically significant as the p value was <0.01. Conclusion: CD56 is a potentially good immunohistochemical marker for differentiating papillary thyroid carcinoma from other benign follicular lesions of the thyroid especially in differentiating follicular variant PTC from FA in equivocal cases.

Original languageEnglish
Pages (from-to)111-119
Number of pages9
JournalMalaysian Journal of Pathology
Volume40
Issue number2
Publication statusPublished - 1 Aug 2018

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Adenoma
Thyroid Gland
Carcinoma
Hyperplasia
Autoimmune Thyroiditis
Neoplasms
Factor IX
Thyroid Neoplasms
Tertiary Care Centers
Paraffin
Formaldehyde
Epithelial Cells
Papillary Thyroid cancer
Growth

Keywords

  • Benign thyroid lesions
  • CD56
  • Follicular adenoma
  • Papillary thyroid carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

Muthusamy, S., Azhar Shah, S., Abdullah Suhaimi, S. N., Kassim, N., Mahasin, M., Mohd Saleh, M. F., & Md Isa, N. (2018). CD56 expression in benign and malignant thyroid lesions. Malaysian Journal of Pathology, 40(2), 111-119.

CD56 expression in benign and malignant thyroid lesions. / Muthusamy, Santhia; Azhar Shah, Shamsul; Abdullah Suhaimi, Shahrun Niza; Kassim, Norina; Mahasin, Mazne; Mohd Saleh, Muhammad Fakhri; Md Isa, Nurismah.

In: Malaysian Journal of Pathology, Vol. 40, No. 2, 01.08.2018, p. 111-119.

Research output: Contribution to journalArticle

Muthusamy, S, Azhar Shah, S, Abdullah Suhaimi, SN, Kassim, N, Mahasin, M, Mohd Saleh, MF & Md Isa, N 2018, 'CD56 expression in benign and malignant thyroid lesions', Malaysian Journal of Pathology, vol. 40, no. 2, pp. 111-119.
Muthusamy S, Azhar Shah S, Abdullah Suhaimi SN, Kassim N, Mahasin M, Mohd Saleh MF et al. CD56 expression in benign and malignant thyroid lesions. Malaysian Journal of Pathology. 2018 Aug 1;40(2):111-119.
Muthusamy, Santhia ; Azhar Shah, Shamsul ; Abdullah Suhaimi, Shahrun Niza ; Kassim, Norina ; Mahasin, Mazne ; Mohd Saleh, Muhammad Fakhri ; Md Isa, Nurismah. / CD56 expression in benign and malignant thyroid lesions. In: Malaysian Journal of Pathology. 2018 ; Vol. 40, No. 2. pp. 111-119.
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abstract = "Introduction: Thyroid cancer is the most common endocrine malignancy with more than 95{\%} originating from follicular epithelial cells. Diagnostic dilemma may arise in occasional cases such as when an encapsulated nodule with a follicular growth pattern exhibits clear nuclei with grooves making it difficult to distinguish a follicular adenoma from encapsulated follicular variant papillary thyroid carcinoma. This study aimed to evaluate the diagnostic utility of an immunohistochemical marker, CD56, to distinguish between benign and malignant thyroid lesions. Materials and Methods: We retrospectively studied CD56 expression in 54 benign and 54 malignant thyroid lesions using archival formalin fixed paraffin-embedded tissue blocks for the study period from January 2010 to December 2015, diagnosed in a tertiary hospital. Results: CD56 was expressed in 52/54 (96.3{\%}) of benign specimens and only 24/54 (44.4{\%}) of malignant ones. The malignant specimens comprised 31 (57.4{\%}) papillary thyroid carcinomas (PTC), 11 (20.3{\%}) follicular carcinomas (FC), seven (13{\%}) medullary thyroid carcinomas (MC), one (1.9{\%}) poorly differentiated carcinoma (PC) and four (7.4{\%}) anaplastic carcinomas (AC). CD56 was not expressed in 28/31 (90.3{\%}) of the PTCs, 1/11 (9.1{\%}) FCs, 1/4 (25{\%}) of ACs while all MCs and the PD were positive. The benign group comprised nodular hyperplasias (29/54), lymphocytic thyroiditis (10/54), follicular adenomas (FA) (14/54) and one hyalinising trabecular tumour. CD56 was expressed in all the benign cases except one FA and one nodular hyperplasia. Thirteen of the 14 FAs were CD56 positive. The difference in expression between benign and malignant tumours was statistically significant as the p value was <0.01. Conclusion: CD56 is a potentially good immunohistochemical marker for differentiating papillary thyroid carcinoma from other benign follicular lesions of the thyroid especially in differentiating follicular variant PTC from FA in equivocal cases.",
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AU - Azhar Shah, Shamsul

AU - Abdullah Suhaimi, Shahrun Niza

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AU - Mahasin, Mazne

AU - Mohd Saleh, Muhammad Fakhri

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AB - Introduction: Thyroid cancer is the most common endocrine malignancy with more than 95% originating from follicular epithelial cells. Diagnostic dilemma may arise in occasional cases such as when an encapsulated nodule with a follicular growth pattern exhibits clear nuclei with grooves making it difficult to distinguish a follicular adenoma from encapsulated follicular variant papillary thyroid carcinoma. This study aimed to evaluate the diagnostic utility of an immunohistochemical marker, CD56, to distinguish between benign and malignant thyroid lesions. Materials and Methods: We retrospectively studied CD56 expression in 54 benign and 54 malignant thyroid lesions using archival formalin fixed paraffin-embedded tissue blocks for the study period from January 2010 to December 2015, diagnosed in a tertiary hospital. Results: CD56 was expressed in 52/54 (96.3%) of benign specimens and only 24/54 (44.4%) of malignant ones. The malignant specimens comprised 31 (57.4%) papillary thyroid carcinomas (PTC), 11 (20.3%) follicular carcinomas (FC), seven (13%) medullary thyroid carcinomas (MC), one (1.9%) poorly differentiated carcinoma (PC) and four (7.4%) anaplastic carcinomas (AC). CD56 was not expressed in 28/31 (90.3%) of the PTCs, 1/11 (9.1%) FCs, 1/4 (25%) of ACs while all MCs and the PD were positive. The benign group comprised nodular hyperplasias (29/54), lymphocytic thyroiditis (10/54), follicular adenomas (FA) (14/54) and one hyalinising trabecular tumour. CD56 was expressed in all the benign cases except one FA and one nodular hyperplasia. Thirteen of the 14 FAs were CD56 positive. The difference in expression between benign and malignant tumours was statistically significant as the p value was <0.01. Conclusion: CD56 is a potentially good immunohistochemical marker for differentiating papillary thyroid carcinoma from other benign follicular lesions of the thyroid especially in differentiating follicular variant PTC from FA in equivocal cases.

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