Macák J

Bio: Macák J is an academic researcher. The author has contributed to research in topics: Thyroid carcinoma & Thyroid. The author has an hindex of 1, co-authored 1 publications receiving 69 citations.

Diffuse sclerosing variant of papillary thyroid carcinoma.

Abstract: Five cases of the diffuse sclerosing variant of papillary thyroid carcinoma (DSPC) were presented. The fifth case was discovered in a statistically not defined series of carcinomas of the thyroid gland. DSPC were found in 5.7% of 70 cases of thyroid papillary carcinoma. All the cases described showed a similar histological picture. In the first case a "dominant nodule" was found. Immunohistologically B-cell markers were mostly proved on lymphocytes of the focal lymphocytic infiltration. Accumulation of Langerhans cells was present in the tumour foci. The finding of these cells is regarded as a sign of an enhanced immunological defense mechanism. The clinical follow-up interval of patients was 3 to 9 years. Less favourable prognosis of DSPC as compared with classical papillary carcinomas could not be confirmed in this series.

Aggressive Variants of Papillary Thyroid Cancer: Incidence, Characteristics and Predictors of Survival among 43,738 Patients

Abstract: Background The diffuse sclerosing (DSV) and tall cell (TCV) variants are considered aggressive subtypes of papillary thyroid cancer (PTC) for which data are limited.

Papillary thyroid carcinoma with prominent hobnail features: a new aggressive variant of moderately differentiated papillary carcinoma. A clinicopathologic, immunohistochemical, and molecular study of eight cases.

Abstract: Papillary thyroid carcinomas (PTC) are the most common thyroid tumors that usually have a good prognosis. Recurrence, metastases, and cancer death may occur in a few patients and are more commonly associated with more aggressive tumors, such as tall cell, columnar cell, or diffuse sclerosing variants of the PTC. We present the clinicopathologic, immunohistochemical, and molecular features of a rare aggressive variant of the PTC showing prominent hobnail features. The patients included 6 females and 2 males. Ages ranged from 28 to 78 years (mean 57.6). Patients presented with a neck mass and cervical lymphadenopathy. Tumor size ranged from 1.0 cm to 4.0 cm (mean 2.5 cm). The tumors were usually multifocal with variably sized complex papillary structures lined by cells with increased nuclear/cytoplasmatic ratios and apically placed nuclei that produced a surface bulge (hobnail appearance). Thyroglobulin, TTF-1, HBME-1, and p53 were positive in all cases, and there was membrane staining for beta-catenin and E-cadherin. The proliferative index with Ki67 ranged from 2% to 20% with a mean of 10%. BRAF mutation was present in 4/7 (57.1%) cases. Distant metastases to liver, lung, bone, brain, muscle, and pancreas developed in 5 patients. The average follow-up time was 77.2 months. Four patients died of disease after a mean of 42.8 months. Two patients are alive with disease after 4 and 87 months, respectively. Two patients are alive without disease after 120 and 236 months. PTC with a prominent hobnail pattern is a moderately differentiated PTC variant with aggressive clinical behavior and significant mortality.

Papillary Thyroid Carcinoma: Prognostic Index for Survival Including the Histological Variety

Abstract: Background Numerous prognostic factors have been studied for survival in patients with papillary thyroid carcinoma (PTC), although there are few multivariate studies that include the histological variety of PTC Hypothesis There are prognostic factors that influence survival in a series of patients with PTC, including the histological variety, and a new prognostic index (PI) for survival can be formulated by accounting for these factors Design A retrospective study Setting A university hospital department of surgery Patients Between January 1970 and December 1995, 200 patients undergoing surgery for PTC were observed (mean follow-up, 8 years) Main Outcome Measures A univariate analysis was done for survival rates using the Kaplan-Meier estimation method The possible prognostic factors were evaluated using a multivariate analysis according to the Cox model We formulated a PI and defined 3 risk groups (low, medium, and high) for mortality Results Of the 200 patients, 175 (875%) are still alive Of the 25 deaths, 19 (95%) were due to the tumor The survival was 975% at 1 year, 928% at 5, 895% at 10, and 839% at 15 and 20 years The prognostic factors obtained after the multivariate analysis were age, tumor size, extrathyroid spread, and histological variant of the PTC The PI is calculated as follows: PI = (2 × size) +(6 × spread) + (2 × variant) + (3 × age) As for the risk groups, the low-risk group showed a mortality of 0%; the medium-risk group, 171%; and the high-risk group, 765% Conclusions The histological variety of PTC has prognostic value for survival in patients with PTC As risk factors for PTC mortality, we consider an age of 50 years or older, a tumor larger than 4 cm, the existence of extrathyroid spread, and a certain histological subtype of PTC With these risk factors, it is possible to formulate a PI and classify patients into low-, medium-, and high-risk groups for mortality