PMC6817485_01
Pre (A-D) and post-neoadjuvant (E-H) histopathological analysis of the classical papillary thyroid carcinoma surgical specimens. (A,B) Complex, branching, randomly oriented papillae with fibrovascular areas (HE 100X); (C,D) papillae lined by cuboidal cells, nuclei overlap with finely dispersed optically clear chromatin (HE 400X); (E) papillae showing fibrotic fibrovascular areas (HE 400X); (F) preserved neoplastic architecture (HE 400X); (G) foreign body granuloma (HE 100X); (H) densely fibrotic area showing old hemorrhage and residual infiltrative carcinoma (HE 100 X). Expression of VEGF, VEGFR-1, VEGFR2, and CD31 immunolabeling in pre (I-L) and post-neoadjuvant (M-P) surgical specimens, respectively. (I) light positivity in tumor cells and vascular endothelium; (J) highlighted a prominent vascular network in the neoplastic papillae; (K) negative staining; (L) intense staining in tumor cells maintained; (M,O) slightly increased positivity in tumor cells; (P) intense staining in tumor cells; (N) reduction in number and the caliber of vessels within fibrovascular areas (all 400X).
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F1
Carcinoma cell nuclei overlapped and showed finely dispersed optically clear chromatin (Figures 1A-D). Compared to the pre neoadjuvant specimen, residual papillae were fibrotic and extensive areas of stromal fibrosis showing old hemorrhage and foreign body inflammation were observed (Figures 1E-H). Expression of VEGF, VEGFR-1, VEGFR2, and CD31 immunolabeling was assessed in pre and post-neoadjuvant surgical specimens (Figures 1I-L). On the other hand, a reduction in the number and caliber of vessels within fibrovascular cores when analyzing the CD31 antibody was observed (Figures 1M-P).
Thyroid CT scans pre (A) and after 6 months (B) of neoadjuvant sorafenib therapy.
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Immediate postoperative computed tomography (CT) displayed a lesion measuring 6.8 x 3.4 x 3.4 cm (Figure 2A) in contact with the carotid space, infiltrating the fat surrounding the vascular structures, with lateral deviation and reduction of the caliber of the internal jugular vein and no cleavage plan with the cervical musculature. After 6 months of treatment, the large cervical lesion showed a reduction of 70% of the largest diameter from baseline (2.0 x 1.9 x 1.6 cm:Figure 2B) in CT, defined as a partial response by RECIST criteria.