BRAF mutation in solid cell nest hyperplasia associated with papillary thyroid carcinoma. A precursor lesion?

• Published in: Human pathology Vol. 40; no. 7; pp. 1029 - 1035
• Main Authors: Cameselle-Teijeiro, José, MD, PhD, Abdulkader, Ihab, MD PhD, Pérez-Becerra, Raquel, BSc, Vázquez-Boquete, Angel, BSc, Alberte-Lista, Lara, MD, Ruiz-Ponte, Clara, PhD, Forteza, Jerónimo, MD, PhD, Sobrinho-Simões, Manuel, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2009; Elsevier; Elsevier Limited
• Subjects: Biological and medical sciences; BRAF gene; Carcinoma, Papillary - genetics; Carcinoma, Papillary - pathology; Cell Transformation, Neoplastic - genetics; Endocrinopathies; Genetic testing; Goiter - etiology; Goiter - pathology; Humans; Hypotheses; Investigative techniques, diagnostic techniques (general aspects); Lasers; Male; Malignant tumors; Medical sciences; Microcarcinoma; Middle Aged; Mutation; Papillary carcinoma; Pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Proto-Oncogene Proteins B-raf - genetics; Solid cell nests; Stem cells; Therapy; Thyroid; Thyroid cancer; Thyroid gland; Thyroid Neoplasms - genetics; Thyroid Neoplasms - pathology; Thyroid. Thyroid axis (diseases); Tumors; BRAF gene; Papillary carcinoma; Microcarcinoma; Solid cell nests; Thyroid; Endocrinopathy; Endocrine gland; Hyperplasia; Thyroid diseases; Thyroid gland; Malignant tumor; Precursor; Anatomic pathology; BRAF Gene; Association; C-Onc gene; Genetics; Lesion; Mutation; Cell; Papillary thyroid carcinoma; Protooncogene; Cancer
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2008.11.015

Summary We describe a case of solid cell nest hyperplasia associated with papillary thyroid carcinoma in a 48-year–old man with goiter. The entire gland was examined; in 1 section, the cells of 1 solid cell nest were in close contact with a follicular variant of papillary microcarcinoma. A second follicular variant of papillary microcarcinoma, 1 follicular adenoma, hyperplastic nodules, and some lymphoid aggregates were also found. Scattered p63-positive cells were found in the second papillary microcarcinoma. After microdissection, the same BRAFV600E mutation was found both in a pool of 5 solid cell nests and in the adjacent papillary microcarcinoma. BRAFV600E mutation and the previously unreported BRAFG593D mutation along with p.G606G silent change were found in the second papillary microcarcinoma, but no mutations were detected in the follicular adenoma or in the 2 other pools of solid cell nests screened for BRAF gene mutations. These findings support a histogenetic link between the main cells of solid cell nests and papillary thyroid carcinoma, and suggest solid cell nest hyperplasia as a precursor lesion of papillary thyroid carcinoma.