Abstract
In order to better understand the spatial distribution of thyroid vessels, a series of benign and malignant thyroid lesions were studied with three-dimensional (3D) histological stereomicroscopic reconstruction. Cases consisted of normal autoptic thyroids (n=6), colloid goitres (n=6), Basedow’s disease (n=2), follicular adenoma (FA) (n=4) one of which with Hurthle cells (HC), minimally invasive, well-differentiated follicular carcinoma (FTC) (n=1), well-differentiated FTC with HC (n=1), poorly differentiated FTC (n=13) with extensive angioinvasion, papillary carcinoma (PTC) (n=8) and medullary carcinoma (MTC) (n=1). From each selected nodule, parallel sections were obtained for 3D reconstruction and for histological and immunohistochemical studies. In normal thyroid, large vessels were located at the periphery of the gland with smaller branches present within the thyroid parenchyma that encircled follicles. The same pattern of vascularisation is maintained in lesions showing a follicular architecture as colloid goitre, Basedow’s disease, FA, well-differentiated FTC and the follicular variant of PTC. Neoplastic lesions, at variance with non-neoplastic lesions, contained rare anastomoses. Poorly differentiated FTC and MTC contained large intratumoural vessels surrounding avascular areas corresponding to solid neoplastic cellular sheets with necrosis. PTC were more vascularised and contained numerous vascular anastomoses. In conclusion, the present data indicate that the vascular distribution is related to the follicular, papillary or solid type of growth. Vascular anastomoses and intratumoural vessels surrounding solid avascular areas are signs of malignancy.
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References
Burger PC, Scheithauer BW (eds) (1994) Tumors of the central nervous system. Fascicle 10, Third series Atlas of Tumor Pathology, Armed Forces Institute of Pathology, Bethesda, MD
Dorji T, Foschini MP, Eusebi V (2002) Three dimensional images in thyroid pathology. 17th International Meeting of the Adriatic Society of Pathology, Brjuni (Croatia) 27–29 June
Faverly D, Holland R, Burgers L (1992) An original stereomicroscopic analysis of the mammary glandular tree. Virchows Archiv 421:115–119
Faverly D, Burgers L, Bult P, Holland R (1994) Three dimensional imaging of mammary ductal carcinoma in situ: clinical implications. Semin Diagn Pathol 11:193–198
Fontanini G, Vignati S, Pacini F, Pollina L, Basolo F (1996) Microvessel count: an indicator of poor outcome in medullary thyroid carcinoma, but not in other types of thyroid carcinomas. Mod Pathol 9:636–640
Foschini MP, Tot T, Eusebi V (2002) Large section (macrosection) histologic slides. In: Silverstein MJ (ed) Ductal carcinoma in situ of the breast, 2nd edn. Lippincott Williams & Wilkins, Philadelphia
Foschini MP, Gabrielli L, Dorji T, Kos M, Lazzarotto T, Lanari M, Landini MP (2003) Vascular anastomoses in dichorionic diamniotic fused placentas: a three dimensional (3D) reconstruction. Int J Gynecol Pathol 22:359–361
Frates MC, Benson CB, Doubilet PM, Cibas ES, Marqusee E (2003) Can color Doppler sonography aid the prediction of malignancy in thyroid nodules? J Ultrasound Med 22:127–133
Frigerio B, Capella C, Eusebi V, Tenti P, Azzopardi JG (1983) Merkel cell carcinoma of the skin: the structure and origin of normal Merkel cells. Histopathology 7:229–249
Gabrielli L, Lazzarotto T, Foschini MP, Lanari M, Guerra B, Eusebi V, Landini MP (2003) Horizontal in utero acquisition of a viral infection. J Clin Microbiol 41:1329–1331
Gaudin PB, Rosai J (1995) Florid vascular proliferation associated with neural and neuroendocrine neoplasms. A diagnostic clue and potential pitfall. Am J Surg Pathol 19: 642–652
Jackson PA, Merchant W, McCormick CJ et al (1994) A comparison of large block macrosectioning and conventional techniques in breast pathology. Virchows Archiv 425:243–248
Katoh R, Hemmi A, Komiyama A, Kawaoi A (1999) Confocal laser scanning microscopic observation in angioarchitectures in human thyroid neoplasms. Hum Pathol 301226–1231
Rago T, Vitti P, Chiovato L, Mazzeo S, De Liberi A, Miccoli P, Vacava P, Martino E, Pinchera A (1998) Role of conventional ultrasonography and color flow Doppler sonography in predicting malignancy in “cold” thyroid nodules. Eur J Endocrinol 138:41–46
Ramsed JD (2000) Angiogenesis in the thyroid gland. J Endocrinol 166:475–480
Wellings SR, Jensen HM (1973) On the origin and progression of ductal carcinoma in the human breast. J Natl Cancer Inst 50:1111–1118
Wong NACS, Willott J, Kendall MJ, Sheffield EA (1999) Measurement of vascularity as a diagnostic tool for well differentiated thyroid tumours: comparison of different methods of assessing vascularity. J Clin Pathol 52:593–597
Acknowledgements
I would like to acknowledge Mr. Massimo Romagnoli for his artwork and Mrs. Luciana Muzzi for technical help. This study was supported by grants from the Ministry of University, Scientific and Technological Research (Rome) and University of Bologna.
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Foschini, M.P., Papotti, M., Parmeggiani, A. et al. Three-dimensional reconstruction of vessel distribution in benign and malignant lesions of thyroid. Virchows Arch 445, 189–198 (2004). https://doi.org/10.1007/s00428-004-1035-z
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DOI: https://doi.org/10.1007/s00428-004-1035-z