PMID- 29512025
OWN - NLM
STAT- MEDLINE
DCOM- 20190307
LR  - 20201105
IS  - 1936-0568 (Electronic)
IS  - 1936-055X (Print)
IS  - 1936-055X (Linking)
VI  - 12
IP  - 4
DP  - 2018 Dec
TI  - Ubiquitin Immunostaining in Thyroid Neoplasms Marks True Intranuclear Cytoplasmic 
      Pseudoinclusions and May Help Differentiate Papillary Carcinoma from NIFTP.
PG  - 522-528
LID - 10.1007/s12105-018-0905-7 [doi]
AB  - Papillary thyroid carcinoma (PTC) is defined by an invasive growth pattern and 
      classic nuclear features: enlarged, grooved, overlapping nuclei with chromatin 
      clearing and intranuclear cytoplasmic pseudoinclusions (INCP). True INCPs are 
      characteristic of PTC, but may infrequently be seen in noninvasive follicular 
      thyroid neoplasms with papillary-like nuclear features (NIFTP). Nuclear 
      abnormalities that mimic INCP ("pseudo-pseudoinclusions") are common in a variety 
      of thyroid lesions. H&E and ubiquitin-stained whole tissue sections of classic 
      PTC (n = 25) and NIFTP (n = 35) were evaluated. On H&E, true INCPs were present 
      in all (100%) PTCs and absent in all NIFTPs (0%). Pseudo-pseudoinclusions were 
      present in 13 (37%) NIFTPs. In 24 (96%) PTCs, ubiquitin was strongly expressed 
      within INCPs. In NIFTPs, optically clear nuclei or pseudo-pseudoinclusions did 
      not express ubiquitin (0/35). Occasionally, nuclear vacuoles in NIFTP 
      demonstrated a marginated staining pattern, in which strong ubiquitin expression 
      was seen at the periphery of the nucleus, but the central pale area was negative. 
      In addition, 2 NIFTPs demonstrated intrafollicular psammomatoid calcifications 
      which were strongly ubiquitin-positive. Psammoma bodies in PTC were 
      ubiquitin-negative in the majority of cases. We report a previously undescribed 
      finding: strong ubiquitin expression in true INCPs in PTC, absence of true INCPs 
      in NIFTP, and absence of ubiquitin expression in pseudo-pseudoinclusions in 
      NIFTP. This finding supports the difference between true INCPs (found only in 
      PTC) and pseudo-pseudoinclusions (found in NIFTP). Using strict histologic 
      criteria and ubiquitin immunostaining, the presence of true pseudoinclusions may 
      exclude a diagnosis of NIFTP. Caution should be exercised when interpreting 
      nuclear vacuoles or pseudo-pseudoinclusions.
FAU - Cracolici, Vincent
AU  - Cracolici V
AUID- ORCID: 0000-0002-6458-5517
AD  - Department of Pathology, The University of Chicago Medical Center, 5841 S. 
      Maryland Avenue, Chicago, IL, 60637, USA. vincent.cracolici@uchospitals.edu.
FAU - Krausz, Thomas
AU  - Krausz T
AD  - Department of Pathology, The University of Chicago Medical Center, 5841 S. 
      Maryland Avenue, Chicago, IL, 60637, USA.
FAU - Cipriani, Nicole A
AU  - Cipriani NA
AD  - Department of Pathology, The University of Chicago Medical Center, 5841 S. 
      Maryland Avenue, Chicago, IL, 60637, USA.
LA  - eng
PT  - Journal Article
DEP - 20180306
PL  - United States
TA  - Head Neck Pathol
JT  - Head and neck pathology
JID - 101304010
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Ubiquitin)
SB  - IM
MH  - Adenocarcinoma, Follicular/*diagnostic imaging
MH  - Biomarkers, Tumor/*analysis
MH  - Cell Nucleus/pathology
MH  - Diagnosis, Differential
MH  - Humans
MH  - Immunohistochemistry/methods
MH  - Inclusion Bodies/pathology
MH  - Thyroid Cancer, Papillary/*diagnosis
MH  - Thyroid Neoplasms/*diagnosis
MH  - Ubiquitin/*analysis
PMC - PMC6232225
OTO - NOTNLM
OT  - NIFTP
OT  - Papillary thyroid carcinoma
OT  - Pseudoinclusions
OT  - Thyroid
OT  - Ubiquitin
COIS- The authors declare that they have no conflict of interest.
EDAT- 2018/03/08 06:00
MHDA- 2019/03/08 06:00
PMCR- 2019/03/06
CRDT- 2018/03/08 06:00
PHST- 2018/01/25 00:00 [received]
PHST- 2018/02/28 00:00 [accepted]
PHST- 2018/03/08 06:00 [pubmed]
PHST- 2019/03/08 06:00 [medline]
PHST- 2018/03/08 06:00 [entrez]
PHST- 2019/03/06 00:00 [pmc-release]
AID - 10.1007/s12105-018-0905-7 [pii]
AID - 905 [pii]
AID - 10.1007/s12105-018-0905-7 [doi]
PST - ppublish
SO  - Head Neck Pathol. 2018 Dec;12(4):522-528. doi: 10.1007/s12105-018-0905-7. Epub 
      2018 Mar 6.