Renal-cell carcinoma with intranuclear inclusions metastatic to thyroid: A diagnostic problem in aspiration cytology

Authors

  • Andrey Y. Gritsman M.D., Ph.D.,

    1. Department of Pathology and Head and Neck Surgry, The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston, Houston TX 77030
    Search for more papers by this author
  • Steven M. Popok M.D.,

    1. Department of Pathology and Head and Neck Surgry, The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston, Houston TX 77030
    Search for more papers by this author
  • Jae Y. Ro M.D., Ph.D.,

    Corresponding author
    1. Department of Pathology and Head and Neck Surgry, The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston, Houston TX 77030
    • Department of Pathology, University of Texas, M.D. Anderson Hospital, 1515 Holcombe Blvd, Houston, TX 77030
    Search for more papers by this author
  • Roupen H. Dekmezian M.D.,

    Corresponding author
    1. Department of Pathology and Head and Neck Surgry, The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston, Houston TX 77030
    • Department of Pathology, University of Texas, M.D. Anderson Hospital, 1515 Holcombe Blvd, Houston, TX 77030
    Search for more papers by this author
  • Randal S. Weber M.D.

    1. Department of Pathology and Head and Neck Surgry, The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston, Houston TX 77030
    Search for more papers by this author

Abstract

A case of renal-cell carcinoma (RCC) exhibiting prominent intranuclear inclusions in a metastasis to the thyroid is presented. RCC had been treated in this patient by right nephrectomy 7 yr earlier and by left partial nephrectomy 5 yr earlier; the patient had also received radiation to the neck 4 yr earlier for carcinoma in situ of the left true vocal cord. Aspiration performed on a rapidly enlarging mass in the left lobe of the thyroid revealed both clusters of tumor cells and single tumor cells with prominent intranuclear inclusions. Definitive distinction between a primary and metastatic neoplasm was difficult on the aspiration specimen. Subsequent thyroidectomy confirmed the diagnosis of metastatic renal-cell carcinoma with intranuclear inclusions by histologic, immunohistochemical, and ultrastructural analysis. The differential diagnosis by aspiration cytology of thyroid neoplasms that contain intranuclear inclusions is discussed.

Ancillary