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Spectrum of lesions derived from branchial arches occurring in the thyroid: from solid cell nests to tumors

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Abstract

There is a group of lesions in the head and neck region derived from branchial arches and related structures which, when inflamed, are characterized by the formation of cysts lined by squamous or glandular epithelium and surrounded by a heavy inflammatory infiltrate rich in germinal centers. In the thyroid, the main source of various structures which may cause diagnostic dilemma is the ultimobranchial body. To investigate the spectrum of such thyroid lesions, the consultation files were reviewed for thyroid samples containing pathological structures regarded to arise from the ultimobranchial body. Positive reaction with antibodies against CK5/6, p63, galectin 3, and CEA, and negative reaction with antibodies against thyroglobulin, TTF-1, and calcitonin were used to confirm the diagnosis. The specific subtype of the ultimobranchial body-derived lesion was then determined based on histological examination of H&E-stained slides. Twenty-one cases of ultimobranchial body-derived lesions were retrieved from the consultation files, 20 of them along with clinical information (M/F = 6/14, mean age 55 years, range 36–68 years). Lesions derived from the ultimobranchial body were classified as follows: (hyperplastic) solid cell nests (nine cases), solid cell nests with focal cystic change (five cases), cystic solid cell nests (two cases), branchial cleft-like cyst (four cases), and finally a peculiar Warthin tumor-like lesion (one case). We suggest that the common denominator of these structures is that they all arise due to activation of inflammatory cells around the vestigial structures, which leads to cystic dilatation and proliferation of the epithelial component.

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Acknowledgments

The study was supported by the Ministry of education, youth and sports grant SVV-2017-260 39.

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Authors and Affiliations

  1. Sikl’s Department of Pathology, University Hospital Plzen, Medical Faculty in Plzen, Charles University in Prague, Edvarda Benese 13, Plzen, 305 99, Czech Republic

    Kristyna Srbecka, Kvetoslava Michalova, Magdalena Dubova, Marian Svajdler, Michal Michal & Ondrej Daum

  2. Biopticka laborator s.r.o, Plzen, Czech Republic

    Kvetoslava Michalova, Radmila Curcikova, Michael Michal Jr., Magdalena Dubova, Marian Svajdler & Ondrej Daum

  3. Department of Pathology, Liberec Regional Hospital, Liberec, Czech Republic

    Radmila Curcikova

  4. Biomedical Center, University Hospital Plzen, Medical Faculty in Plzen, Charles University in Prague, Plzen, Czech Republic

    Michael Michal Jr.

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  1. Kristyna Srbecka
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  2. Kvetoslava Michalova
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  3. Radmila Curcikova
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  7. Michal Michal
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  8. Ondrej Daum
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Correspondence to Ondrej Daum.

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The study design has been approved by the local ethics committee (Charles University, Medical School Plzen) LEK FN Plzen. For this type of study, formal consent is not required.

Funding

This study was supported by the Ministry of education, youth and sports grant SVV-2017-260 39.

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The authors declare that they have no conflict of interest.

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Srbecka, K., Michalova, K., Curcikova, R. et al. Spectrum of lesions derived from branchial arches occurring in the thyroid: from solid cell nests to tumors. Virchows Arch 471, 393–400 (2017). https://doi.org/10.1007/s00428-017-2201-4

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  • DOI: https://doi.org/10.1007/s00428-017-2201-4

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