C-cell hyperplasia

被引:27
作者
Guyetant, S. [1 ]
Blechet, C.
Saint-Andre, J-P
机构
[1] CHRU Tours, Serv Anat & Cytol Pathol, Hop Trousseau, F-37044 Tours, France
[2] Univ Tours, INSERM, U618, Tours, France
[3] CHRU Tours, Serv Anat & Cytol Pathol, Hop Bretonneau, Tours, France
[4] CHU Angers, Serv Anat Pathol, F-49033 Angers, France
关键词
C-cell; thyroid; hyperplasia; RET; MEN-II;
D O I
10.1016/S0003-4266(06)72585-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Routine calcitonin assay programs and recent studies on the natural history of familial medullary thyroid carcinoma (MTC) have greatly added to our understanding of C-cell hyperplasia (CCH) and refined its classification. This article is an update on CCH physiopathology related to clinical presentation. With this combined approach, two types of CCH that differ by their physiological characteristics can be identified: neoplastic CCH and reactive (also called physiological) CCH. Neoplastic CCH is caused by a germline mutation of the RET protooncogene in a multiple endocrine neoplasia type 2 (MEN 2) syndrome. It progresses to MTC following a time line that depends on the RET mutation involved. CCH may actually be a misnomer for a neoplastic condition that some authors have proposed to call "in situ-MTC". Reactive CCH is considered to be caused by a stimulus that is external to the C-cell, and its premalignant potential is not documented. Many situations such as hypercalcemia, hyperparathyroidy, chronic lymphocytic thyroiditis or follicular tumors have been associated with reactive CCH, the pathogenesis of which remains unclear. But C-cell density in normal patients is subject to important variability, and several studies have demonstrated the dramatic male predominance in physiological CCH when hypercalcitoninemia was a random discovery. These data suggest that a number of conditions which were previously associated with reactive CCH might be purely fortuitous. Our clinical/pathological confrontation contributes to appropriately distinguishing between various CCH types, and in turn to identify the best way of managing patients.
引用
收藏
页码:190 / 197
页数:8
相关论文
共 52 条
[1]   C-cell hyperplasia and medullary thyroid microcarcinoma [J].
Albores-Saavedra, J ;
Krueger, JE .
ENDOCRINE PATHOLOGY, 2001, 12 (04) :365-377
[2]   C-CELL HYPERPLASIA IN THYROID-TISSUE ADJACENT TO FOLLICULAR CELL TUMORS [J].
ALBORESSAAVEDRA, J ;
MONFORTE, H ;
NADJI, M ;
MORALES, AR .
HUMAN PATHOLOGY, 1988, 19 (07) :795-799
[3]  
BARBOT N, 1991, ANN ENDOCRINOL-PARIS, V52, P109
[4]  
BECKNER ME, 1990, ARCH PATHOL LAB MED, V114, P1049
[5]   SYMPTOMATIC C-CELL HYPERPLASIA ASSOCIATED WITH CHRONIC LYMPHOCYTIC THYROIDITIS [J].
BIDDINGER, PW ;
BRENNAN, MF ;
ROSEN, PP .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1991, 15 (06) :599-604
[6]  
DELELLIS RA, 1977, LAB INVEST, V36, P237
[7]   Germline RET 634 mutation positive MEN 2A-related C-cell hyperplasias have genetic features consistent with intraepithelial neoplasia [J].
Diaz-Cano, SJ ;
de Miguel, M ;
Blanes, A ;
Tashjian, R ;
Wolfe, HJ .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2001, 86 (08) :3948-3957
[8]   Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: Experience in 10,864 patients with nodular thyroid disorders [J].
Elisei, R ;
Bottici, V ;
Luchetti, F ;
Di Coscio, G ;
Romei, C ;
Grasso, L ;
Miccoli, P ;
Iacconi, P ;
Basolo, F ;
Pinchera, A ;
Pacini, F .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2004, 89 (01) :163-168
[9]  
Franc B., 1998, Archives d'Anatomie et de Cytologie Pathologiques, V46, P100
[10]  
FRANC B, 1991, MEDULLARY THYROID CA, V211, P159