Scarring in papillary carcinoma of the thyroid: report of two new cases with exuberant nodular fasciitis-like stroma

Histopathology. 1999 Nov;35(5):418-22. doi: 10.1046/j.1365-2559.1999.035005418.x.


Aims: To describe two new cases of papillary carcinoma of the thyroid with exuberant nodular fasciitis-like stroma, one of which was characterized by previously unreported transformation into a poorly differentiated lesion. Moreover, we explore the presence of TGF-beta to help to clarify the pathogenesis of the collagen formation.

Methods and results: The case characterized by an aggressive behaviour exhibited areas of transformation into a poorly differentiated (insular) carcinoma of the thyroid. In both cases, as revealed by immunohistochemistry, neoplastic cells produced and secreted high amounts of TGF-beta. On the contrary, TGF-beta immunoreaction was never present in the normal thyroid or in papillary carcinomas without collagen bundles, while a weak, exclusively intracellular reaction was present in a patchy manner in cases showing intratumoral fibrous bundles.

Conclusions: The rare variant of papillary thyroid carcinoma characterized by exuberant stroma may give rise to more aggressive lesions, as do other histotypes of differentiated thyroid carcinomas. TGF-beta, the fundamental cytokine which mediates scarring and activation of myofibroblasts, most probably induces the exuberant stroma.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Papillary / metabolism
  • Carcinoma, Papillary / pathology*
  • Carcinoma, Papillary / surgery
  • Cell Transformation, Neoplastic
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Keloid / etiology
  • Keloid / metabolism
  • Keloid / pathology*
  • Male
  • Stromal Cells / metabolism
  • Stromal Cells / pathology*
  • Thyroid Gland / metabolism
  • Thyroid Neoplasms / metabolism
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery
  • Transforming Growth Factor beta / metabolism


  • Transforming Growth Factor beta