PMC5095500_01
(A-F) Medullary thyroid carcinoma. (A) Medullary thyroid carcinoma (MTC), macroscopic appearance. LTL: Left thyroid lobe (Bar = 1cm). (B) Structures of papillary appearance, formed by cubic and cylindrical cells with intensely acidophilic cytoplasm arranged over a fibrovascular stroma (arrows) (HE. Bar = 100mum). (C) Positive reaction of neoplastic cells with anti-calcitonin antibody, arranged in nests delimited by fibrovascular tissue septa (arrows) (Bar = 100mum). (D) Positive cytoplasmic reaction with anti-calcitonin antibody. Rounded nuclei and apparent nucleoli (Bar = 50mum). (E) Positive cytoplasmic reaction in neoplastic cells with anti-synaptophysin antibody. A fibrovascular tissue septum can be observed (arrow) (Bar = 100mum). (F) Positive cytoplasmic reaction of neoplastic cells with anti-synaptophysin antibody (Bar = 50 mum).
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F1
A 2 cm hard mass was noted with peripheral vascularization in the middle of the left thyroid lobe (Fig. 1A). More than 60% of neoplastic cells showed intense positive cytoplasmic reaction to anti-calcitonin antibody (Fig. 1C,D). Cytoplasmic staining with anti-synaptophysin antibody was intensely positive in more than 90% of neoplastic cells (Fig. 1E,F).
(A-F) Pheochromocytoma. (A) Right adrenal gland, macroscopic appearance with abdominal phrenic vein (APV) and caudal vena cava (CVC) tumor invasion (B) Right adrenal gland, longitudinal section, neoplasia with congestive, hemorrhagic appearance. No cortical tissue observed macroscopically (Bar = 1 cm). (C) Left adrenal gland, macroscopic appearance with APV invasion (D) Left adrenal gland (macroscopic appearance) longitudinal section. Please note the hemorrhagic appearance of the neoplasia and thinning of the adrenal cortex (arrows) (Bar = 1 cm). (E) Positive cytoplasmic reaction of neoplastic cells with anti-synaptophysin antibody. Cells form nests delimited by fibrovascular septa (arrow), with vascular congestion (*) (Bar = 50 mum). (F) Polyhedral cells, cytoplasm reactive to anti-synaptophysin antibody (arrow). Cells with rounded nuclei, dispersed chromatin and small nucleoli (Bar = 50 mum).
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F2
Abdominal phrenic vein (APV) and the CVC were being invaded by the neoplasia (Fig. 2A). Upon dissection, it appeared firm and hemorrhagic, and adrenal cortex area was not recognizable macroscopically (Fig. 2B). The left adrenal gland was altered in shape and size (4.3 cm long and 2.2 wide), with APV invasion (Fig. 2C). Macroscopically, within the adrenal gland, noticeable hemorrhagic areas and thinning of the adrenal cortex were observed (Fig. 2D). The lesion also showed intense vascular congestion and some necrosis areas (Fig. 2E). Cytoplasmic staining with anti-synaptophysin antibody was moderately positive in 60% of neoplastic cells (Fig. 2F).
(A-D) Parathyroid adenoma. (A) Parathyroid adenoma (PA) macroscopic appearance, next to the right thyroid lobe (RTL). (B) Parathyroid adenoma was dissected in half and fixed in 10% buffered formalin. (C) Chief cell adenoma parathyroid (HE. Bar = 100mum). (D) Irregular cords of polyhedral cells with basophilic granular cytoplasm, with large rounded nuclei with dispersed chromatin and smaller eosinophilic cells with pyknotic nucleus (HE. Bar = 50mum).
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F3
The parathyroid tissue showed a proliferative process formed by irregular cords of polyhedral cells with basophilic granular cytoplasm, with large rounded nuclei with dispersed chromatin and smaller eosinophilic cells with pyknotic nucleus (Fig. 3C,D).