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: 28 March 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://www.pathologyoutlines.com/topic/thyroidsclerosing.html. Accessed March 29th, 2017.
Definition / General
  • Indolent mucoepidermoid carcinoma with fibrosis and eosinophil infiltrate in a background of sclerosing Hashimoto thyroiditis (Am J Surg Pathol 1991;15:438)
  • Different carcinogenesis from mucoepidermoid carcinoma of salivary gland (Mod Pathol 2000;13:802, Mod Pathol 2017 Mar;30:329)
  • May derive from squamous metaplasia or ultimobranchial body rests (Mod Pathol 2004;17:526)
  • Can have lymph nodes metastasis, extracapsular spread, vascular invasion, and perineural invasion are common, but death as a result of disease is uncommon
Essential Features
  • Squamous and mucus secreting cells with fibrosis and eosinophil infiltrate in a background of sclerosing Hashimoto thyroiditis
Epidemiology
  • Almost always women (M / F = 1 / 16)
  • Mean age: 55 years
  • Associated with Hashimoto’s thyroiditis and solid cell nest hyperplasia
Etiology
  • Associated with sclerosing Hashimoto thyroiditis
  • Possibly derives from metaplastic squamous epithelium or solid cell nest
  • Negative for MAML2 rearrangements (compared to salivary mucoepidermoid carcinoma) (Mod Pathol 2017 Mar;30:329)
Clinical Features
  • Slowly growing thyroid mass in patients with sclerosing Hashimoto thyroiditis Cold on radionuclide scan
  • Although lymph nodes metastasis, extracapsular spread, vascular invasion, and perineural invasion are common, death as a result of disease is uncommon
Radiology Description
  • Ultrasound scan: ill defined, heterogeneous andhypo echoic 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

Micro 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
  • Mucous 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)
Micro Images

Images hosted on Pathout server:
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Small irregular strands of tumor cells (AFIP)



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Various images

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Tumor cells with a keratin pearl

Cytology Description
  • Atypical squamous cells, mucocytes, eosinophilic mucin, may mimic squamous cell /anaplastic carcinoma
Cytology Images

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Deep cytoplasmic eosinophilia

Positive Stains
Negative Stains
Differential Diagnosis