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Archive-the Korean Journal of Pathology(1967~2008)
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  Vol.29, No.6:756-765, December 1995
Immunohistochemical and Ultrastructural Studies on the Histogenesis of Thyroid Undifferentiated Carcinoma

Jeong Myoung-Ja, Moon Woo-Sung, Lee Young-Hye, Kang Myoung-Jae, Choi Ho-Yeul, Kim Sang-Ho, Lee Dong-Geun

Department of Pathology, Chonbuk University Medical School, ,Chonju 560-180, Korea

Histologic, immunohistochemical and ultrastructural studies were performed on 6 cases ofundifferentiated thyroid carcinoma to study the histogenesis of the undifferentiated thyroid carcinoma, to determine the most useful markers for diagnosing these tumors and to investigatethe nature of osteoclast-like giant cells rarely observed in these tumors. For the immuno-histochemical study, a panel of antibodies to epithelial (cocktailed keratin, low molecular weight keratin, CEA), mesenchymal(vimentin, desmin, actin, FVIIIRAg) endocrine(calcitonin, chromogranin), lymphocytic(LCA), histiocytic(慣-l-ACT, 慣-1-AT, lysozyme, CD68), and Schwann cell(S-100 protein) markers were used. The following results were obtained; 1) Well differentiated carcinoma was associated with 2 cases of spindle cell type and 1 case of giant cell type of undifferentiated thyroid carcinoma and a transitional zone between the welldifferentiated and undifferentiated lesions was observed. 2) All of the examined cases expressed keratin, and 3 tumors expressed CEA. 3) All the mesenchymal markers, LCA, S-100 protein, calcitonin, and chromogranin were not expressed. Vimentin was coexpressed with keratin in 4 cases. 4) Osteoclast-like giant cells were observed in 1 case of spindle cell type. They expressed CD68 but not keratin. 5) Ultrastructural study revealed the desmosomes between the tumor cells and non-neoplastic, follicular, thyroid epithelial cells.The above results indicate that undifferentiated thyroid carcinoma originates from follicular epithelial cell, keratin is the most useful marker for diagnosis of this tumor, and the osteoclast-like giant cells are histiocytic in nature and reactive, rather than neoplastic.
Key Words : Thyroid, Undifferentiated carcinoma, Immunohistochemistry, Ultrastructure

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