Thyroid gland
Other carcinoma
Sclerosing mucoepidermoid carcinoma with eosinophilia

Author: Shuanzeng Wei, M.D., Ph.D. (see Authors page)
Editor: Zubair W. Baloch, M.D., Ph.D.

Revised: 11 April 2017, last major update March 2017

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Sclerosing mucoepidermoid carcinoma with eosinophilia
Cite this page: Sclerosing mucoepidermoid carcinoma with eosinophilia. PathologyOutlines.com website. http://pathologyoutlines.com/topic/thyroidsclerosing.html. Accessed May 29th, 2017.
Definition / general
Essential features
  • Squamous and mucus secreting cells with fibrosis and eosinophilic infiltrate in a background of sclerosing Hashimoto thyroiditis
Epidemiology
  • Almost always women (M / F = 1 / 16)
  • Mean age: 55 years
  • Associated with Hashimoto thyroiditis and solid cell nest hyperplasia
Etiology
  • Associated with sclerosing Hashimoto thyroiditis
  • Possibly derives from metaplastic squamous epithelium or solid cell nests
  • Negative for MAML2 rearrangements, typically seen in salivary mucoepidermoid carcinoma (Mod Pathol 2017;30:329)
Clinical features
  • Slowly growing thyroid mass in patients with sclerosing Hashimoto thyroiditis
  • Cold on radionuclide scan
  • Death due to disease is uncommon, although lymph nodes metastases, extracapsular spread, vascular invasion; and perineural invasion are common
Radiology description
  • Ultrasound scan: ill defined, heterogeneous and hypoechoic nodule
Case reports
Gross description
  • White, homogenous, firm, usually ill defined border
Gross images

Images hosted on Pathout server:

Contributed by Dr. Mark R. Wick

Well circumscribed tumor (not typical) with dense fibrosis (AFIP)

Mucoepidermoid carcinoma,
sclerosing type

Microscopic (histologic) description
  • Infiltrating solid / nested squamous tumor cells with mild to moderate atypia in dense fibrohyaline stroma with marked eosinophil infiltration; keratin pearls and keratin debris can be identified
  • mucus secreting cells, small mucin pools present; background of chronic lymphocytic thyroiditis
  • Lymph nodes metastasis, extracapsular spread, vascular invasion and perineural invasion are common
  • May have focal clear cells (Ann Diagn Pathol 2003;7:348)
Microscopic (histologic) images

Images hosted on Pathout server:

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Small irregular strands of tumor cells (AFIP)



Images hosted on other servers:

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Various images

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Tumor cells with a keratin pearl

Cytology description
  • Atypical squamous cells, mucocytes, mucin and eosinophils; may mimic squamous cell / anaplastic carcinoma
Cytology images

Images hosted on other servers:

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Epithelial pearl-like structure

Positive stains
Negative stains
Differential diagnosis
Board review question #1
    Which one is the correct description for sclerosing mucoepidermoid carcinoma with eosinophilia:

    A. Sclerosing mucoepidermoid carcinoma with eosinophilia is not associated with Hashimoto thyroiditis
    B. Lymph nodes metastases, extracapsular spread, vascular invasion and perineural invasion are common
    C. Death due to sclerosing mucoepidermoid carcinoma with eosinophilia is common
    D. Eosinophil infiltration is common, and no keratin pearls and keratin debris are seen
    E. The squamous component is highly malignant
Board review answer #1
    B. Lymph nodes metastases, extracapsular spread, vascular invasion and perineural invasion are common.

    Death due to disease is uncommon, although lymph nodes metastases, extracapsular spread, vascular invasion and perineural invasion are common.