CLINICOPATHOLOGICAL STUDY OF CLEAR-CELL TUMORS OF THE THYROID - AN EVALUATION OF 22 CASES

Twenty-two cases of partial or wholly composed clear-cell thyroid tumo rs were reviewed to differentiate between a primary nodule and metasta tic clear-cell renal carcinoma in the thyroid. Pathological reevaluati on of HE-stained specimens, immunohistochemical observation using anti -thyroglobulin (TG) antibody, and periodic acid-Schiff (PAS) staining were performed, The pathological characteristics in metastases from th e kidney have a greater tendency to demonstrate a strikingly clear cyt oplasm with small nuclei, rich vascularization, and a trabecular arran gement of tumor cells than do primary thyroid cases, The immunohistoch emical TG staining in conjunction with PAS staining for the recognitio n of follicular colloid could provide much more reliable information o f primary cases compared to that using TG staining alone, Clinically, in primary cases, the female:male ratio is substantially higher while the mean age is lower than in metastatic cases reflecting differentiat ed thyroid carcinoma. In conclusion, immunohistochemical staining for TG with PAS staining for the recognition of follicular colloid proved to be the most sensitive method for identifying primary clear cell thy roid tumors, In addition, a careful assessment of past and/or present kidney disorders to rule out metastatic renal cell carcinoma is advisa ble, Age, gender, and physiological findings are also informative when differentiating between them.