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(American Journal of Pathology. 1999;155:1499-1509.)
© 1999 American Society for Investigative Pathology

Regular Articles

Mixed Medullary-Follicular Thyroid Carcinoma

Molecular Evidence for a Dual Origin of Tumor Components

Marco Volante*, Mauro Papotti*, Jürgen Roth{dagger}, Parvin Saremaslani{ddagger}, Ernst J. M. Speel{ddagger}, Ricardo V. Lloyd§, J. Aidan Carney§, Philipp U. Heitz{ddagger}, Gianni Bussolati* and Paul Komminoth{dagger}{ddagger}

From the Department of Biomedical Sciences and Oncology,*
University of Turin, Turin, Italy; the Division of Cell and Molecular Pathology{dagger}
and the Department of Pathology,{ddagger}
University of Zürich, Zürich, Switzerland; and the Department of Pathology and Laboratory Medicine,§
Mayo Clinic and Foundation, Rochester, Minnesota

Mixed medullary-follicular carcinomas (MMFCs) are tumors of the thyroid that display morphological and immunohistochemical features of both medullary and follicular neoplasms. The histogenetic origin and possible molecular mechanisms leading to MMFCs are still unclear. To address these questions, we have isolated the two histological components of 12 MMFCs by (laser-based) microdissection, analyzed them for mutations in the RET proto-oncogene and allelic losses of nine loci on six chromosomes, and studied the clonal composition of MMFCs in female patients. Our results provide strong evidence that the follicular and medullary components in MMFCs are not derived from a single progenitor cell, because the seven tumors amenable for analysis consistently exhibited a different pattern of mutations, allelic losses, and clonal composition. We also demonstrate that follicular structures in MMFCs are often oligo/polyclonal and more frequently exhibit hyperplastic than neoplastic histological features, indicating that at least a subset of MMFCs are composed of a medullary thyroid carcinoma containing hyperplastic follicles.




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